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THE 



NEW JERSEY 



MEDICAL REPORTER, 



AND 



TRANSACTIONS 



OF THE 



NEW JERSEY MEDICAL SOCIETY. 



EDITED BY JOSEPH PARRISH, ED. 




BURLINGTON: 

PUBLISHED BY S. W. BUTLER, M. D. 

1851. 







v. 



INDEX. 



Abscesses, cause of pointing towards the 

skin, 192. 
Acids, table of, 297. 
Address by James Paul, M. D., 1. 

by W. Nichols, M. D., 75 

by S. H. Pennington, M. D., 35. 

by J. F.Ward, M.D., 236. 
Adjuster, Jarvis', 153. 

review of remarks on, 95. 
Advertiser, Newark Daily v. Quackery, 

356. 
After-pains, misplaced, 242. 
Alimentary substances, absorption of, 370. 
Allopathy a misnomer, 210. 
American Medical Association, 258. 

delegates to, 220. 

letter from Dr. Yardley, 298. 

transactions of for 1850, 152. 

transactions for 1851, 261. 

prize essays, 366. 
American Scientific Association, 364. 
Amputation below the knee. 331. 

not followed by suppuration, 214. 
Anaesthetic action, 226. 
Arsenic, tobacco an antidote to, 367. 
Asthma, nitric acid in, 159. 

Baths, prolonged tepid as sedatives, 70. 
Bibliographical notices, 64. 
Birth after death of mother, 370. 
Bladder and genital organs, malformation 

of, 308. 
Break-bone fever — Dengue, 66. 

Cervix femoris, intra-capsular fracture of, 

339. 
Chloroform in obstetrics, 48. 

frictions of in chorea, 228. 
Cheese poisoning, 3L6. 
Cholera infantum, nature of, 277. 
Cholera a misnomer, 211. 

cause of virulence of in Jamaica, 197. 
Chorea, treatment by chloroform frictions, 
228. 

a case of, 357. 
Circular, Dr. Flint's, 161. 

Dr. Gross', 358. 

Dr. Paul's, 303. 

Prize essays, Am. Med. Assoc, 366. 
Cod-liver oil in diseases of the eye, 226. 

use of, 318. 
Coffee and cafeine, therap. employment of, 

371. 
Colleges, classes and graduates, list of for 

1851, 225. 
Collodion, abortive power of in small-pox, 

190, 338. 
Colics, recurring, treatment of, 27. 



Colon, secreting function of, 133. 

Consul Uitions, 225. 

Correspondents, to, 65, 186, 220. 

Creasote in diarrhoea, 332. 

Croup, contributions to history, &c, 144. 

Crowing child, 52. 

Cupping instrument, simple, 276. 

Curiosities, medical, 52. 

Cutaneous poison, annual return of, 55. 

Deep sea soundings, 364. 

Delano, Dr. Jesse, death of, 355. 

" Delusions, medical," notice of, 217. 

Dengue — Break-bone fever, 66. 

Dental Science, American Journal of, 154. 

District medical societies, 65. 

to, 303. 
District society meetings, 303. 
Diuretics, external application of in dropsy, 

227. 
Diuretic formula, 369. 

Dracontium fcetidum, remarks on use of,310. 
Dress, cause of uterine displacements, 359. 
Drugs, cause of adulteration of, 342. 
Dysentery, pathology and treatment of,347. 

Eclectic department, our, 158. 

Editor's table, 221, 259, 324. 

Education, practical views of medical. 56. 

Empiricism in the medical profession, 236. 

Encephaloid disease of kidney, 93. 

Enteric fever, essay on, 288. 

Ergot, action of in producing retention of 

placenta, 165. 
Eruptive fevers, by Geo. Gregory, M.D., 

notice of, 320. 
Erysipelas, treatment of by tincture of 

chloride of iron, 327. 
Exchanges, &c, 165, 185, 221, 324. 

Facts, medical, 330. 

Food, as connected with the decay of the 

teeth, 1. 
Foot, destruction of by fire ; patient under 

anaesthetic influence of oil of turpentine, 

331. 
Forensic medicine in New Jersey, 107. 
Fracture, intra-capsular of cervix femoris, 

339. 

Good's Family Flora, 184. 

Haines, Dr. Job, death of, 354. 
Hair blanched from sudden emotions. 332. 
Hemorrhage uterine, kite- tail plug in, 70. 
Hernia, principles in treatment of, 326. 

strangulated, morphia in, 224. 
Homoeopathy in Great Britain, 61. 
»' Homoeopathy Illustrated," notice of, 259. 



IV 



INDEX. 



Hooping-cough, cochineal in, 190. 
Hydrangea arborescens, a new remedy in 

lithiasis, 44. 
Hydrophobia, treatment of, 39. 

Indigenous plants, remarks on use of, 309. 
Infants, diminution in weight of new born, 

192. 
Insanity, a case cured by chloroform, 333. 
Iodine, influence of, on development of 

fcetus, 67. 

Kermes mineral as an antidote to strychnia, 

68. 
Kidney, encephaloid disease of. 93. 

Lacteals, functions of, 370. 
Law, medical, 218, 255. 
supplement to, 222. 
Lithiasis, a new remedy in, 44. 
Lunatic Asylum, New Jersey (plate), 180. 

Mammary inflammation, use of collodion 

in, 339. 
Manganese, some therapeutical uses of, 174. 
Marsh, Dr. E. J., remarks on his death by 
Dr. Pennington, 85. 
resolutions occasioned by death of, 89. 
Medical Society, New Jersey, minutes of 
semi-annual meeting, 1850, 85. 
minutes of annual meeting, 1851, 243. 
officers and censors for 1851, 246. 
report of standing committee, 1851,229. 
report from Hunterdon County, 232. 
" Menstruation, diseases of." by E. J. Tilt, 
notice of, 215. 
precocious, 69. 
Meteorological Record, 65. 

tables, 72, 162. 
Mettauer's aperient solution, 337. 
Minutes of District Medical Society for 
Mercer Co., 156. 

for Burlington Co., 213. 
for Monmouth Co., 298. 
Miscellany, 260. 
Monomania, a case of, 336. 
Monstrosity, 312. 
Monthly, change to, 185. 
Morphia in strangulated hernia, 224. 
Musk, destruction of odor of by camphor, 
70. 

Nashville Journal of Medicine and Surgery, 
259. 

Nervous collapse after parturition, 334. 

New York Register of Medicine and Phar- 
macy, 154. 

Novel case, 247. 

Obituary, 261. 

Obstetrical case, report of, 364. 
Old age, 75. 

Opium, poisoning from treated by electro- 
magnetism, 326. 

Penis, luxation of, 191. 

Periodic, or recurring colics, treatment of, 

27. 
Pharmacopoeia U. S. for 1851, notice of, 

251. 
Phosphate of lime, 257. 
" Physicians' Prescription Book," notice 

of, 301. 



Podophyllum peltatum, remarks on use of, 

309. 
Poisoned wounds, "■ Bone Fever," 208. 
Prepuce, varicose dilatation of vessels, 370. 
Professors and laymen, 321. 
Protessorial changes, 323. 
Puerperal fever, prophylactic treatment of, 

227. 

Quackery, Newark Daily Advertiser vs., 

356. 
Quackery, 362. 
Quinine, removal of bitter taste of, 70. 

Reform, medical, 312, 341. 
Reporter, the, 153. 

chaDge to a monthly, 185. 
Resolutions, Dr. Paul's, 244. 

Dr. Coleman's, 245. 
Rheumatism, subcutaneous puncture in, 71. 
Ricinus communis as a galactagogue and 
emmenagogue, 189. 

Sanitary institutions, 328. 

Santonine, 352. 

Scarlet fever, malignant, yeast in, 194. 

Scirrhous disease, case of, 91. 

Scurvy, new remedy for, 307. 

Scutellaria laterifolia as a nervine, 327. 

Skin, eruptions of during pregnancy, 224. 

Snake poison, antidote against, 194. 

Societies, district medical, 65. 

Specimen numbers, 186. 

Spine, gun-shot wound of, 368. 

Spleen, rupture of, 172. 

Sprains, treatment of, 304. 

Statistics, medical, 370, 

Stethoscope and Virginia Medical Gazette, 

155. 
Subscribers, a word with, 302. 
Syncope after delivery, 326. 

Tartar emetic, very minute doses of in 

phthisis and asthma, 71. 
Testicle, retained in groin, extirpation, 340. 
Tetanus, traumatic, successfully treated, 

173. 
The teeth, 307. 

decay of, 366. 
Tobacco an antidote to arsenic, 367. 
Toe-nail, operation for ingrowing. 191. 

Uterus, rupture of sac in at sixth month, 
53. 
rupture of, recovery, 195. 
Uterine displacements, dress cause of, 359. 

Variola, collodion to prevent pitting in, 
190, 338. 

Veratrum viride in fevers, &c, 187. 

Vertebras, fractured, 339. 

" Vesico-vaginal fistula treated by opera- 
tion," notice of, 217. 

Volume, our fourth, 63. 

Wood's catalogue, 155. 

Yeast in malignant scarlet fever, 194. 

Zoo-adynamia, essay on, notice of, 140. 



THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. 'iV. TENTH MONTH (OCTOBER), 1850. No. 1. 

DISTRICT MED. SOCIETY for the COUNTY OF MERCER. 



THE FOOD AND THE TEETH. 

OBSERVATIONS 

On the Inorganic Constituents of the Food of Children, as 
connected with the Decay of the Teeth, and the Physical 
Constitution of Women in America. 

Read before the " District Medical Society of the County of Mercer ," 23 d July, 1850, 

by James Paul, M. D. 

The subject to which I have the pleasure of directing 
your attention is, not only in a physiological point of view, 
one of interest, but in its application to the preservation of 
health — the tendency to improve the general condition and 
physical constitution of the human family inhabiting this 
great continent — a continent abounding, as it does, in all 
the productions which a Bountiful Creator, in his benefi- 
cence, bestows on man — cannot be otherwise than of great 
and paramount importance. 

At a period somewhat now remote, the celebrated natu- 
ralist Buffon, alluding to the animals of this continent, 
advanced the following opinions : — 

1st. That the animals common both to the Old and New 
Worlds are smaller in the latter. 

2d. That those belonging to the New are on a smaller 
scale. 

3d. That those which have been domesticated in both, 
have degenerated in America. 

4th. That, on the whole, it exhibits fewer species. 
vol. iv. — 1 



2 DR. PAUL S ADDRESS. 

These opinions, Mr. Jefferson, in his "Notes on Virginia," 
undertook, and it is generally considered successfully, to 
controvert ; yet, however repugnant to the general idea the 
opinion as to the tendency of those animals which have 
been domesticated in America from other countries to de- 
generate, it is an undeniable and much to be regretted fact, 
that the human family, and more particularly the female 
portion of that family, have declined in the vigor and 
strength of their physical constitution. 

I wish not to be misunderstood : I say it is a melancholy 
fact, too well known to the observant physiologist, that 
increase of strength, and development of frame, have not 
been attained by the intermarrying of members of the 
human family of different nations on this continent ; but 
the reverse is too observable : the physical frame of the 
female sex has degenerated — calling loudly for the aid of 
science to arrest an evil of so much magnitude. 

Let us for a moment contemplate the female form, as 
seen on this broad continent. In no country in the world 
are children more fair and beautiful ; and as the young girl 
grows up to womanhood, we see in her a full realization of 
that being forming in the hands of Divinity, portrayed by 
the poet, as seen by Adam in his dream : — 

" Under his forming hands, a creature grew, 
Manlike, but different sex ; so lovely fair, 
That what seemed fair in all the world, seemed now 
Mean, or in her summed up, in her contained, 
And in her looks ; " — 

We see this young and lovely being — the forehead well 
developed — the countenance, rather elongated, relieved of 
the harsher outline of some of the European nations — with 
fragile form, and small, yet well-developed bust, flitting for 
a few short years among us, and then — yes, then there 
comes a change. Ere five and twenty summers pass, this 
flower begins to fade — the rounded form shrinks — the 
bloom of health decays ; and if she escapes the fell destroy- 
ing angel's death-like grasp, a wreck of former self remains. 



DR. PAUL S ADDRESS. 6 

Why should this be so ? The robust of other countries 
come to this continent — they live in comfort — their food is 
excellent in quality — their progeny is like themselves — but 
even now, in the very first generation, does the degenerating 
process make itself manifest — the teeth begin to decay ; 
and girls, while yet children, have to visit the dentist to 
have them cleansed, scraped, and plugged. 

Now this brings us at once to the head and front of 
our subject ; and if we can point out the first cause of this 
decay of what should be as strong as adamant, it may be 
the means of helping us in our investigation. That there 
is something radically wrong in our system of rearing 
the young, to which this misfortune is in a great measure 
owing, I am free to confess, is my firm opinion. I would 
indeed it were in my power, in pointing out the evil, to be 
as successful in detailing the cause, that we may apply the 
remedy. Still, although perhaps unable to accomplish all 
I wish, my observations may not be without their weight, 
and induce others, more observant, more scientific, and 
more competent to the task, to follow up an investigation so 
fraught with advantages to our fellow beings. 

It is certainly to be deplored that the females of this con- 
tinent, descendants of European parents, should be so much 
afflicted with caries of the teeth — the decay of parts formed 
of substances which enter into the composition of some of 
our hardest minerals — marble, bone-earth and fluor-spar ; 
and this decay unfortunately occurs in early life — in girls 
yet at school ; and many a young woman, ere she has at- 
tained a marriageable age, has had to replace the natural 
with the unnatural, though more enduring enamel of the 
artist's formation. This ought not to be : God made all 
mankind alike ; in no portion of the earth are nations 
found who lose their hands, or feet, or tongue, or eyes ; and 
there can be no cause why the inhabitants of this land 
should lose their teeth. It is not so in the olden countries 
from whence the progenitors of the present race have come ; 
nor is it so in the West India Islands, which may almost 



4 DR. PAUL S ADDRESS. 

be considered as part of this great continent. So excellent 
is the structure of the teeth of savage nations, that some 
tribes in Africa, I think the Mocoes and Mundingoes, file 
all the front teeth, so that they shall be separated and 
form sharp points, the better to tear the uncooked animal 
food. 

One cause of this affliction is, in the mind of many, at- 
tributed to the great and sudden changes of temperature 
experienced on this continent — the thermometer rising and 
falling 20, 30, and even 40 degrees in twelve hours. But 
if attributable to these sudden changes, we know that 
sudden expansion by means of heat, or sudden contraction 
by means of cold, causes the particles of which bodies are 
composed to tear themselves asunder ; consequently to 
crack, break, and fall in pieces. But this is not the case 
with the teeth of our females ; a caries or decay commences 
most generally in the side of the tooth, extending to the 
enamel, which is sometimes involved in the destruction, at 
other times, it is left a crust or shell to snap and break off 
in small pieces, when unable to resist the pressure of what- 
ever may be placed against it ; besides, the teeth are for 
the most part sheltered from these sudden changes, and 
kept at a temperature nearly amounting to blood heat at 
all seasons. I do not think we can place the general de- 
struction of the teeth, and consequent affliction of the 
females of America, to this cause. I fear we must rather 
look for it to constitutional weakness, and this constitutional 
weakness to a deficiency of the inorganic or earthy constitu- 
ents being taken into the system, more particularly at an 
early period of life. 

If I am correct in this opinion, and reason, philosophy, 
and a thorough examination of physiological facts in both 
the animal and vegetable economy, tend far to bear out 
these views, then if we would try and correct this lament- 
able state of things, let us commence at the very beginning, 
and make ourselves acquainted by examining the structure 
and composition of the teeth, and then we shall be more 



DR. PAUL'S ADDRESS. 5 

able to understand what is required to aid nature in their 
formation and consequent preservation. 

First, then, let us make ourselves acquainted with the 
structure and composition of the teeth. The teeth are 
nearly allied to bone in structure ; both having earthy de- 
posits, intermixed with fibres and cells of gelatine, which, 
by consolidation, gives form and strength — in the case of 
bone, to bear the weight of the various parts, and afford 
protection to the different organs of the body ; and in the 
case of teeth, to cut and grind the food required for the 
formation, support, and reparation of its various parts. 

Now, teeth are composed of three different substances, 
and these three are disposed according to the purposes re- 
quired of them; they are, cementum or crusta petrosa, 
dentine (known as ivory in the tusk of the elephant), and 
enamel. The cementum or crusta petrosa, corresponds in 
all especial particulars with bone ; possessing its charac- 
teristic lacunx or small cavities, and being traversed by 
vascular medullary canals, whenever it occurs of sufficient 
thickness ; it is the first covering of the young teeth, and 
may be said to invest the fang of the tooth which enters 
the alveolar process of the jaw. The dentine, or ivory, 
consists of a firmer substance, in which inorganic or mineral 
matter predominates, though to a less degree than in 
enamel. It is traversed by a vast number of very fine 
cylindrical, branching, wavy tubuli, which commence at 
the pulpy-cavity, and radiate towards the surface. The 
diameter of these tubuli, at their largest part, averages 
about one 10,000th of an inch : their smallest are immea- 
surably fine ; so much so, that they cannot possibly re- 
ceive blood, but it is surmised that, like the canaliculi of 
bone, they imbibe fluid from the vascular lining of the 
pulp-cavity, which aids in the nutrition of the tooth. The 
enamel is composed of solid prisms or fibres, about the one 
5,600th of an inch in diameter, arranged side by side, and 
closely adherent to each other ; their length corresponds 
with the thickness of the layer which they form ; and the 



6 dr. Paul's address. 

two surfaces of this layer present the ends of the prism, 
which are usually more or less hexagonal. In the perfect 
state, the enamel contains but an extremely minute quan- 
tity of animal matter. In the centre of the tooth is the 
soft pulpy cavity, which affords a bed for the blood-vessels 
and nerves which supply it with life and sensibility. 

I shall not enter more minutely into the structure of the 
teeth, but may briefly state, that like all other structures of 
the animal body, the component parts are derived and 
deposited from the blood, by that mysterious and incompre- 
hensible power that selects and deposits the necessary con- 
stituents in the formation of the several portions, according 
to the use required. 

Now, in the composition of the teeth, we have first the 
division into organic and inorganic or earthy matter ; and 
we find that the several substances which enter into the 
structure of the teeth, differ chiefly as to the earthy matter 
contained in each. 

Chemical analysis of the incisors, or front teeth of man, 
show that they contain in one hundred parts of each, as 
follows : — 





Cementum. 


Dentine. 


Enamel 


Organic Matter, 
Earthy Matter, 


29.27 
. 70.73 


28.70 
71.30 


3.59 

96.41 



100. 100. 100. 

These proportions will occasionally differ ; in some indi- 
viduals the organic constituents having less than here 
stated, amounting in the dentine only to 21. The analysis 
of bone, however, gives a much larger proportion, viz : 

Organic Matter, .... 32.56 
Earthy Matter, . . . 67.44 

100. 

Let us now take a more complete analysis, showing what 
earthy constituents enter into their composition. Analysis 
of the molar or grinding teeth of man, and of the bones of 



DR. PAUL S ADDRESS. 



the arm and leg of a man of forty, show the following 
proportions : — 



Dentine. 
Inorganic Matter: — 

Phosphate of Lime, with traces 

of Filiate of Lime, . . 66.72 

Carbonate of Lime, . 3.36 

Phosphate of Magnesia, . 1.08 

Salts, &c. ... .83 

Organic Matter, . . . 28.01 



Enamel. 


Bone. 


89.82 


54.61 


4.37 


9.41 


1.34 


1.07 


.88 


2.35 


3.59 


32.56 



100. 100. 100. 

Thus we see the very great proportion of certain earths 
that enter into the structure of the teeth and bone of man, 
the chief substance being the phosphate of lime, familiarly 
known as bone-earth. We find, too, that whereas in ordi- 
nary bone the phosphate of lime constitutes only 54 parts 
in 100, in the enamel of the teeth it is nearly 90 parts in 
100 — while the carbonate of lime in bone amounts to 
9.41, in the enamel of teeth it is only 4.37; the enamel 
being literally almost a mineral in substance, having only 
3.59 parts of animal matter in 100. 

Thus the teeth to be strong and durable, require a large 
quantity of earthy ingredient, particularly lime, to enter into 
their composition. Let us inquire whence it is derived; 
and for this we must examine the blood. 

To allow of such deposits from the blood, it is first neces- 
sary that they should be held in solution in that fluid. You 
are no doubt aware that the blood circulating to every 
portion of the body by means of the heart forcing a certain 
quantity. to the extent say of 2 oz. at every contraction, 
into the aorta or great canal leading from the left ventricle, 
and which, dividing and subdividing into innumerable 
branches, are made to ramify to every part of the body, 
until the extreme branches end in capillary tubes or vessels, 
the calibre of which is so small as not to allow the red 
globules or corpuscles of the blood to enter them, but which 
allows the serous portion to traverse every portion of the 
organized structure, holding in solution all those constitu- 
ents necessary and requisite for the formation and repara- 
tion of its several parts. 



8 DR. PAUL'S ADDRESS. 

In the serous portion of the blood, then, we find contained 
the constituents required for the composition of bone and 
teeth— analysis of 1000 parts of healthy human blood 
giving, according to M. Lecanu, the following proportions : 

Water, ...... 7S0.15 785.5S 

Fibrine, ..... 

Albumen, ..... 

Coloring matter, .... 

Crystalizable fat, 

Fluid fat, 

Extractive matter, uncertain, 

Albumen in combination with Soda, . 

Chlorides of Sodium and Potassium ; 
Carbonates, Phosphates and Sul- 
phates of Potash and Soda, . . 8.37 7.30 

Carbonates of Lime and Magnesia ; 
Phosphates of Lime, Magnesia and 
Iron; Per-Oxide of Iron, . . . 2.10 1.42 

Loss, 2.40 2.50 



2.10 


3.57 


65.09 


69.41 


133.00 


119.63 


2.43 


4.30 


1.31 


2.27 


1.79 


1.92 


1.26 


2.01 



1000. 1000. 

We see by this table, if we subtract or take away the 
proportion of water amounting to 780 parts, and the color- 
ing matter amounting to 133, we shall leave scarcely 90 
parts of organic and earthy material, the salts and earths 
forming upwards of a 10th — the salts being in proportion 
to the earths as 4 to 1. 

Having then traced the constituent portions of the bones 
and teeth to be in the blood, the next consideration is, 
whence are they derived? 

Before entering on this subject farther, let us for a mo- 
ment take a broader and more comprehensive view of what 
must be (most interesting to mothers, and) of great conse- 
quence to the well-being of the infant generation, in a 
short time — in a very few years to become in their turn the 
mothers and fathers of another generation. 

The question then presents itself, as to what is the nou- 
rishment or food best adapted and necessary to the wants 
of an infant, that the foundation may be laid for a strong 
frame and vigorous constitution — for here, we must recol- 
lect, is the starting point in by far the majority of instances. 
We know that in some cases disease is hereditary — that 



DR. PAUL'S ADDRESS. 9 

the offspring unfortunately inherits from the parent consti- 
tutional defects ; but we also know that more misery, suf- 
fering, and constitutional derangement, are entailed on 
children by want of care and improper food in the first 
years of life, by which their hopes of health are blasted, 
and they are doomed to struggle through a weary life, to 
be hurried at last into a premature grave. 

Now, that the frame — that is, the bones, muscles and 
other portions of the infant — may be fully developed, it is 
necessary that it should be supplied with nourishment, 
containing all the constituents required for this important 
undertaking. And this nourishment, by the all-wise or- 
dering of Providence, is contained in the milk secreted 
from the mother's bosom. 

The infant is entirely dependent on the nourishment de- 
rived from its mother, and nature has wisely ordained that 
the secretion from the mother is its very best food ; for we 
find in the composition of milk — that is, healthy milk, 
derived from healthy blood — all those ingredients we have 
hitherto traced as requisite in the formation of the bones 
and teeth, and not only these, but every constituent re- 
quired for the life and growth of the individual ; — milk 
containing the albuminous, saccharine, oleaginous, saline, 
and earthy compounds requisite and necessary for the 
health, strength, and development of the infant child. 

How thankful ought we to be to the all-wise and boun- 
tiful Giver of all good, for this beneficent, this wonderful 
provision in nature, by which there shall be secreted from 
the mother, a fluid so important, having properties blended 
in intimate connection, to afford the requisite substances 
for the support, growth and development of her offspring. 

An analysis of cow's milk gives the following proportions 
of the various constituents ; that of human milk is not so 
elaborate, but contains the average of observations taken 
at fourteen different times from the same individual, by 
Simon. 



10 dr. Paul's address. 



Cow's milk by M. Hai: 


lien. 


Woman's milk by Simon. 




Water, .... 


873.00 


Water, ..... 


S83.6 


Butter, .... 


30.00 


Butter, .... 


25.3 


Caseine, .... 


48.20 


Caseine, ..... 


34.3 


Milk Sugar, . 


43.90 


Milk Sugar and Extractive 




Phosphate of Lime, 


2.31 


Matter, .... 


48.2 


Phosphate of Magnesia, 


.42 


Fixed Salts, 


2.3 


Phosphate of Iron, 


.07 








Chloride of Potassium, 


1.44 




1000. 


Chloride of Sodium, 


.24 







Soda in connection with Ca- 




Maximum of Minim 


um of 


seine, 


.42 


14 observations. 14 observations. 






Butter, . . 54.0 


8.0 




1000. 


Caseine, . 45.2 
Sugar & Extract- 


10.6 






ive Matter, . 62.4 


39.2 






Salts, . . 2.7 


1.6 



Now although, these amounts will no doubt vary, under 
every variety of circumstances, according to the health, 
exercise, passions, and food of the mother, yet they show 
what I particularly wish to impress on your minds, that 
healthy milk contains all the requisites for the nourishment 
of the infant — but then it must be healthy milk, secreted 
from healthy blood, and that blood must derive these ingre- 
dients from the food consumed, otherwise they will be 
taken up from the structures of the body, and hence the 
havoc made in nursing females when a due allowance of 
proper aliment is withheld, and the shrunken body of the 
famished mother is drained to. the last drop, to supply the 
cravings of the death-like and impoverished offspring. 

I have said that the composition of milk in quality and 
quantity, will vary and depend on circumstances. Now 
the mental state exerts a surprising influence on this secre- 
tion, and much more than is usually supposed. It may 
not be irrelevant to mention a few of the cases recorded in 
our journals,* of the influence of strong mental excitement 
on this secretion. 

" A carpenter fell into a quarrel with a soldier billeted 
in his house, and was set upon by the latter with his drawn 
sword. The wife of the carpenter, at first, trembled from 

* From Carpenter's Physiology. 



DR. PAUL'S ADDRESS. 11 

fear and terror, and then suddenly threw herself furiously 
between the combatants, wrested the sword from the sol- 
dier's hand, broke it in pieces, and threw it away. During 
the tumult, some neighbors came in and separated the men. 
While in this state of strong excitement, the mother took 
up her child from the cradle, where it lay playing, and in 
the most perfect health, never having had a moment's ill- 
ness ; she gave it the breast, and in so doing, sealed its 
fate. In a few minutes the infant left off sucking, became 
restless, panted, and sank dead upon its mother's bosom. 
The physician, who was instantly called in, found the child 
lying in the cradle, as if asleep, and with its features undis- 
turbed ; but all his resources were fruitless. It was irre- 
vocably gone." 

"A lady having several children, of which none had 
manifested any particular tendency to cerebral disease, and 
of which the youngest was a healthy infant a few months 
old, heard of the death of the infant child of a friend resid- 
ing at a distance, with whom she had been on terms of close 
intimacy, and whose family had increased cotemporaneously 
with her own. The circumstance naturally made a strong 
impression on her mind, and she dwelt upon it the more, 
perhaps, as she happened at that period to be separated 
from the rest of her family, and to be much alone with 
her babe. One morning shortly after having nursed it, she 
laid it in its cradle, asleep and apparently in perfect health ; 
her attention was shortly attracted to it by a noise, and on 
going to the cradle, she found her infant in a convulsion, 
which lasted for a few minutes, and left it dead." 

" A mother had lost several children in early infancy 
from a convulsive disorder. One infant, however, survived 
the usual fatal period ; but whilst nursing him one morn- 
ing, she had been strongly dwelling on the fear of losing 
him also, although he appeared a very healthy child. In 
a few minutes after the infant had been transferred into 
the arms of the nurse, and while she was urging her mis- 
tress to take a more cheerful view, directing her attention 



12 dr. paul's address. 

to his thriving appearance, lie was seized with a convulsion- 
fit, and died almost instantly." 

These are interesting cases, and tend to show the great 
influence the mental affections exert on the secretion of milk, 
in rendering it deleterious in quality, and unwholesome to 
the infant. 

Returning then to our subject, you will observe by the 
analysis, that cow's milk differs from that of woman in the 
proportions of some of the constituents, that it abounds 
more in butter, but particularly in caseine, or cheese ; and 
on the other hand, that human milk abounds more in the 
saccharine principle, or sugar of milk. Now this points 
out a circumstance from which great benefit may be de- 
rived. It is of very frequent occurrence that infants are 
deprived of the natural nourishment of the mother, and 
diverse opinions are given relative to the food of infants 
by persons who really know very little about the matter; 
one recommends a milk diet, another that the infant must 
be fed upon starch and sugar. 

Now, to enable the infant to receive a nourishment in 
every respect similar to the mother, the knowledge of the 
various proportions which we obtain by chemical analysis, 
enables us to rectify and produce milk very analogous to 
human milk from that of the cow, by diluting it with water 
in the proportion of about half as much again ; that is to a 
pint of milk should be added half a pint of water that has 
been boiled, which will reduce the cheese principle to the 
proper proportion ; add a small portion of cream to restore 
the proportion of butter, and then add sugar until the whole 
is distinctly sweetened, and we have a compound in every 
respect similar to the milk from the human breast. 

To understand the subject of nutrition, allow me to explain 
to you, that food ought to, or must embody two great prin- 
ciples ; one to nourish, the other to give heat to the body. 
And food, when consumed, is applied to one or the other 
of these purposes. Now, in the process of digestion, the 
constituents of the food are separated, and arranged in three 
classes. 



DR. PAUL'S ADDRESS. 13 

1st. All that portion derived from animal food, eggs, the 
curd of milk, the gluten or adhesive portion of wheat and 
other grain, and whatever in animal or vegetable food can be 
rendered into Albumen — of which the best example that can 
be offered in illustration is the white of egg, which is in real- 
ity nearly pure albumen — and the principle is therefore called 
Albuminous. 

2d. All that portion of the food derived from vegetables, 
starch, sugar, &c, that can be converted into sugar in the 
process of digestion. This principle is, therefore, called 
saccharine. 

3d. All the fat, butter, oil, &c, which, when deprived of 
the other substances, is left in the state of oil, and therefore 
called oleaginous. 

Now, of these three the albuminous is the nutrient, and 
the saccharine and oleaginous the calorifacient, or heat giv- 
ing ; and chemical analyses show that they vary in composi- 
tion. 





ALBUMEN. 






SACCHARINE. 


OLEAGINOUS. 




^V 






a.. 












f 


Starch, 


Sugar 


Sugar 


Cane 


Mutton 




Es??s. Wheat. 


A 


rrow Root. 


from Starch. 


of Milk. 


Sugar. 


Fat. 


Carbon, 


55^000 55.01 




44.40 


37.29 


40.00 


42.301 


78.996 


Hydrogen, 


7.073 7.23 




6.18 


6.84 


6.61 


6.384 


11.700 


Nitrogen, 


15.920 15.92 














Oxygen, 






49.42 


55.87 


5293 


51.315 


9.304 


Sulphur, 


i 22.007 21.84 














Phosphorus, 

















You will observe that the albuminous or nutrient differs 
from the saccharine and oleaginous, in containing nitrogen, 
and sulphur and phosphorus, with carbon, hydrogen and 
oxygen, while the latter contains only carbon, hydrogen and 
oxygen — nitrogen being required in those compounds which 
give strength and formation to the frame. 

Now the albuminous, or nutritive, being that portion 
which affords nourishment to the body, contains those con- 
stituents required in the first place for the formation and 
giving strength to the different portions of the body, and 
when fully developed, of repairing the general waste con- 
tinually going on in the system, whether from the usual 



14 dr. Paul's address. 

wear and tear, fractured bones, or the ravages of disease. 
And the saccharine and oleaginous — the calorifacient or 
heat-inaking — to keep up a continual supply of fuel as it 
were, that the body may be kept of a regular and proper 
temperature ; for you are no doubt aware that there is a 
continual supply of carbon, or, in more simple language, of 
charcoal, required to keep up the natural temperature of 
the body ; and what is not required for immediate use is 
stored away in the form of fat, to be called into action as 
occasion requires. 

We have seen in the analysis of milk, that that fluid con- 
tains butter, cheese, and sugar ; consequently we can under- 
stand how an infant can thrive so well upon it — the cheese 
or caseine* of the milk, containing the nitrogenizecl or nu- 
trient principle, which together with the earths and salts con- 
tained in the milk, goes to form the bones, muscles and the 
different tissues of the body — the sugar, which we have 
seen by the analysis contains a large quantity of carbon in 
its composition, going to keep up the temperature of the 
infant, while the butter, in the nature of fat, is stored away 
in a healthy infant, filling up every vacant interstice, caus- 
ing a roundness and plumpness, the pride and joy of the hap- 
py parent. 

Now let us mark the difference of the babe that has 
been denied a milk diet, and is doomed by ignorance to be 
fed on starch and sugar. You will recollect that these 
two substances were composed of carbon, hydrogen and 
oxygen only. By a process of digestion which I need 
not here enter into, such food is converted into sugar, 
the carbon of which becomes the fuel by which the tem- 
perature of the body is kept up — there being no principle 



Carbon, 
Hydrogen, 
Nitrogen, 
Oxygen, ) 
Sulphur, J 



Analysis of 


Alb 


uminous substances found in 


Caseine from 




whey after 


fresh milk. 




coagulation with an acid. 


54.825 




54.96 


. 7.153 




7.15 


15.623 




15.89 


. 22.394 




21.73 
0.36 



dr. paul's address. 15 

in the food to give albumen, there is nothing taken into the 
stomach upon which the gastric fluid can expend its sol- 
vent powers, the infant is, therefore, much troubled with 
acid eructations, and the stomach becomes weak and irrita- 
ble. The want of the nutritive constituent of the food, and 
the earths and salts, &c, necessary and essential for the 
formation of the bones and teeth, show a lamentable defi- 
ciency in the child's development, and there being no fatty 
matter to be laid up, the body is emaciated, the counte- 
nance is ghastly, the flesh and integuments hang soft and 
flabby over the bones, no absolute disease can be detected, 
the child is ravenous and hungry, and the unfortunate babe 
descends to the tomb a spectre and an object of the most 
pitiful description. This is no fancy sketch, but one too 
often met with in the ordinary walks of professional life. 
And why is it so? Simply because the composition of the 
human frame, the component parts of our food requisite to 
produce that frame, and the process of digestion and nutri- 
tion, are so little understood. 

We now advance from infancy to childhood — and this is 
a period when the greatest attention is required in supply- 
ing nutriment to aid nature in the great work of developing 
the body. The child is now deprived of the maternal se- 
cretion, and dependent on food prepared for its use by the 
hand of man — perhaps living in a city, and deprived of 
pure and wholesome milk from the cow. And we know 
there is a vast disproportion in the quality of milk when 
the cow is country fed on the natural productions of the 
farm, and when city fed on slops and grain, the refuse of 
the brewery. 

It is at this age that the great proportion of bony sub- 
stance is deposited ; those of the extremities are lengthened, 
become more compact and stronger, and the substance of 
the teeth is deposited in the cells of gelatinous tissue. How 
necessary is it, then, that this subject should receive the 
utmost attention of parents. It has hitherto been too much 
the custom to leave all this, as belonging entirely to nature 



16 DR. PAUL'S ADDRESS. 

— as a thing we had nothing to do with. We have been 
too much in the habit of considering that nature furnished 
her own materials, and man had nothing to do with her 
operation. The potter cannot fashion the bowl without 
the clay, neither can bone be formed without earth. No, 
my friends, nature must be supplied with the material, 
which, although offered in the most incongruous forms, she 
has the power of decomposing, selecting from, and supply- 
ing for the various purposes required; one portion, as we 
have already stated, to act as fuel in keeping up the tem- 
perature ; another portion she selects to add to the flesh, the 
muscles, skin, and different tissues; and the earths which 
are held in solution, she carries away by vessels adapted 
for that purpose, and deposits them atom by atom, until 
they are so compressed, so strongly impacted together, as 
to become what we call solid bone ; and all this so wonder- 
fully wrought, that as we have seen, small tubes are left in 
the hard stony formations both of the bones and of the 
teeth, that nourishment may be supplied them, holding in 
solution the material of which they are composed, that 
the natural waste and decay may be replaced, and injuries 
repaired. 

It is of this nutrition, and of the earthy matter of which 
the bones and teeth are composed, a deficiency of which is 
attended with results so deplorable, that I particularly wish 
to arrest your attention. 

To what can we attribute the calamity which too often 
befalls the young? I allude to distorted spines, where the 
bones composing the spine, instead of forming a column 
allowing the body to be erect and dignified, are zigzag in 
their course, causing one shoulder to bulge out, and the 
opposite side to bend or double upon itself. This deformity 
has been long understood to arise from a deficiency of lime 
in the composition of the bones of the vertebrae, allowing 
them to fall, press upon, and injure each other, destroying 
the beauty of the fabric, and the health and comfort of the 
individual. 



dr. Paul's address. 17 

Now let us take a glance at the inhabitants of two coun- 
tries, natives of which are no strangers on this continent. 
I take them as examples, because the food of the common 
people of those countries, is well known to be of the most 
common kind. I allude to natives of Scotland and of Ire- 
land — the principal food of the one being oatmeal, and of 
the other, potatoes. We have heard a great deal of the 
famishing poor of those countries, and particularly of the 
latter — of the misery and wretchedness seen in every hovel ; 
and there cannot be a doubt that famine walked through 
the land, when the blight and rot despoiled them of their 
potato crop, on which, for so long a period, they depended 
as the great article of food. Now, allowing all this — allow- 
ing, in the best seasons, the chief article of subsistence has 
been potatoes for breakfast, dinner and supper ; glad indeed 
many of them to get a little animal food once a-week to 
dinner, or even far more seldom — I now ask, what number, 
in the thousands of emigrants from that country who yearly 
arrive at our ports, are there that show a constitution weak, 
fragile, and wanting in physical strength ? Many, no 
doubt, arrive, worn down by disease and suffering, and in 
the last stage of debility ; but let them recover from that 
state, and the robust frame and healthy constitution will be 
again developed ; the bones are strong, the teeth unde- 
cayed, and the muscular energy only wanting opportunity 
to display itself; — in fact, when we wish to denote strength 
in woman, we use the familiar phrase, " strong as an Irish 
woman;" and all this from being reared on potatoes. But 
then, if we examine the analysis of potatoes, we shall find 
contained in 100 parts of dry potatoes, — 

Carbon, 41.1 

Hydrogen, . . . . 5.8 

Nitrogen, ) 45 j 
Oxygen, $ " 

Ashes, . . . . . 5.0 

Here we see that potatoes not only contain the nutrient 
but the earthy constituents.* 

* According to a memorial presented to the French minister, on the propor- 
VOL. IV. — 2 



18 DR. PAUL'S ADDRESS. 

But we have a stronger and more healthy race yet, from 
Scotland and the north of Ireland, who are generally de- 
scendants of the Scotch, and continue, in a great measure, 
the same means in rearing the young. Now, a principal, I 
will not say the principal food of the youth of Scotland, high 
and low, rich and poor, except in the larger cities, amongst 
those who class themselves as more refined and more civil- 
ized, but who number few in proportion, consists, for break- 
fast, at least, of oatmeal — that is, porridge and milk ; and 
milk, potatoes, and wheaten, oaten, and peas bread, or ban- 
nocks, at other times of the day. Animal food amongst the 
poor is a rarity ; a meat dinner on Sunday only, being com- 
mon. Even, among the youth of the better class, butcher's 
meat, or animal food, is by no means a principal article of 
subsistence. And I would particularly remark that Scotch 
oatmeal (the oatmeal generally used throughout Scotland) 
is coarse, and contains much of the bran which invests the 
oat — containing, as it does, a large proportion of the earthy 
constituents required for the production of bone. Analysis 
of 100 parts of dried oats gives : — 

Carbon, . . . . . 50.7 

Hydrogen, .... 6.4 

Oxygen, .... 36.7 

Nitrogen, .... 2.2 

Ashes, ..... 4.6 

I may here casually remark, that the advantage to be 
derived from this wholesome food has not escaped the ob- 
servation of her majesty, Queen Victoria, who appears in the 
multiplicity of her public duties, not to lose sight of the 



tions of nutriment of the means of living, by Dr. Glaser, we find potatoes 
taking no mean rank. 

100 lbs. Wheat Bread contains 30 lbs. of nutritive elements. 



caseine & starch. 

albumen, starch, 

and sugar, 
albumen with 
sugar. 



Flesh 


u 


21 lbs. 


French Beans 


tt 


80 lbs. 


Peas 


tt 


83 lbs. 


Lentils 


(( 


94 lbs. 


Potatoes 


a 


25 lbs. 


Carrots 


tt 


14 lbs. 


Beets 


a 


8 lbs. 



DR. PAUL'S ADDRESS. 19 

equally sacred duties of a mother — and we hear of her son, 
the heir to the crown of Great Britain, being as fond of his 
oatmeal porridge as the meanest peasant child in Scot- 
land. 

I rather doubt, if parents generally have given to this 
subject the attention to which it is entitled. I trust, how- 
ever, that those who have followed me thus far, may be 
impressed with its importance. We cannot shut our eyes 
to the complaint which so generally prevails, of decayed 
teeth — and a moment's reflection will call to mind the 
number of the young and beautiful who are prematurely 
hurried to the tomb, ere yet the bud has expanded into the 
full-developed flower. Nay, comparing the two countries, 
the statistics of life and death communicate to us also the 
important fact, that while the greatest mortality shows it- 
self in England in infancy and childhood, on this side of 
the Atlantic, it is found at a more mature age. 

Neither has the tendency of the physical organization of 
woman on this continent to degenerate, escaped the obser- 
vation of one of our greatest medical philosophers in this 
country,* who regards this retrogression as a national 
calamity, and impresses upon his students the importance 
of the subject, and the propriety of their attention in at- 
tempting to arrest it ; and he particularly specifies the 
great object to be gained in the use of bran-bread, made 
from unbolted flower. On this head, I shall have more to 
say hereafter. 

With these observations, let us now direct our attention 
to what can be offered in remedy of this evil. 

We have already stated, that in no country in the world 
are children more beautiful or more lovely — healthy in 
complexion, quick, smart, and intelligent — active, sprightly, 
and playful in their disposition. Now, in the period from 
infancy until the child becomes mature — let us, at all 
events, say until thirteen or fourteen years, and even to a 

* Dr. Jackson, of Philadelphia. 



20 DR. PAUL'S ADDRESS. 

more advanced age — there is a continued growth — a con- 
tinual deposition of organic and inorganic or earthy parti- 
cles, which are required for the formation of bone, teeth, 
flesh, and every part of the human body. I have shown 
you that the essential ingredients for these several forma- 
tions are all found in the milk of the mother ; conse- 
quently, as long as the infant is deriving nourishment from 
the mother, she ought to partake of good, wholesome, 
nourishing food — that the blood, deriving these principles 
from the food, may be able to supply them in turn to the 
milk from which it is secreted. So long, then, as the 
child is thus nourished, so long is it safe, and the rudiments 
or foundation of a robust frame is laid. And if we are to 
expect, in future life, the stalwart frame of man, or the 
enduring, firmly-knit, compact, and healthy physical con- 
stitution in woman, the organic and inorganic or earthy 
compounds of which that frame is composed must not be 
denied — Nature must be supplied, or Nature will fail. 

It is not for me to dictate to any parent what shall be 
the food of his child — it is enough that I point out for their 
information, what may be required to give, what in com- 
mon language is called "bone and sinew," to their off- 
spring. It is necessary then that the food of children shall 
contain : 

1st. Aliment, having the calorifacient or heat-sustaining 
principle. And this is contained in quite sufficient quantity 
in the usual food — in milk, wheaten bread, potatoes, arrow- 
root, Indian corn, (as mush, hominy, or corn-bread,) in 
most vegetable matter, and in sugar. 

2d. Aliment containing the nutrient principle. And 
this is contained in animal food — the lean of beast, bird, 
and fish — in milk, eggs, wheat, rye, potatoes, beans, &c. 
&c. 

And, 3d. Aliment containing the inorganic or earthy 
constituents — on which depends strength of frame, and 
from which are formed the bones and teeth of the indivi- 



DR. PAUL'S ADDRESS. 21 

dual. And these are contained in milk, eggs, animal food, 
and particularly in wheat, rye, oats, potatoes, &c* 

Of the inorganic constituents contained in wheat, (and 
the same may be said of the other cereal grains,) I have 
already alluded to the benefit to be derived from using 
bread made of unbolted flour. On this subject, allow me 
to refer to the difference of flour having much of the bran 
remaining, and superfine flour, or that in general use 
throughout this country, and on which Prof. Johnston has 
made the following curious but practical observations. 
Examining wheat and flour, as to the amount of the 
nutrient or muscular matter, the fat-forming principle, and 
the bone and saline material, contained in grain in different 
states, he found that 

Muscular Mat. Fat Prin. Bone & Sal. 
In 1000 lbs. of whole grain, there were contained 156 lbs. 25 lbs. 170 lbs. 
" " fine flour, " " 130 « 20 " 60 " 

" " bran, " " .... 60 « 700 " 

% 

Taking the three substances together, according to Prof. 
Johnston, of a thousand pounds, the three substances con- 
tain, of the ingredients mentioned, — 



* On this subject, I extract the following from Carpenter's Physiology, p. 4SS. 
"These substances are contained, more or less abundantly, in most articles gene- 
rally used as food ; and where they are deficient, the animal suffers in conse- 
quence, if they are not supplied in any other way. Thus, common salt exists, 
in no inconsiderable quantity, in the flesh and fluids of animals, in milk, and in 
eggs ; it is not so abundant, however, in plants ; and the deficiency is usually 
supplied to herbivorous animals by some other means. Phosphorus exists also 
in the yolk and white of the egg, and in milk — and it abounds, not only in 
many animal substances used as food, but also (in the state of phosphate of lime 
or bone earth) in the seeds of many plants, especially the grasses. In smaller 
quantities, it is found in the ashes of almost every plant. Sulphur is derived 
alike from vegetable and animal substances. It exists in flesh, eggs, and milk ; 
also in the azotized compounds of plants; and (in the form of sulphate of lime) 
in most of the river and spring-water that we drink. Iron is found in the yolk 
of egg, and in milk, as well as in animal flesh ; it also exists in small quantities 
in most vegetable substances used as food by man — such as potatoes, cabbage, 
peas, cucumbers, mustard, &c. Lime is one of the most universally diffused of 
all mineral bodies ; for there are few animal or vegetable substances in which it 
does not exist. It is most commonly taken in, among the higher animals, com- 
bined with phosphoric acid : in this state it exists largely in the seeds of most 
grasses, and especially in wheat flour. If it were not for their deficiency of 
lime, some of the leguminous seeds (peas) would be more nutritious than 
wheaten flour; the proportion of azotized matter they contain being greater. A 
considerable quantity of lime exists, in the state of carbonate and sulphate, in 
all hard water." 



22 DR. PAUL'S ADDRESS. 



Of muscular matter, 
Of bone material, 
Of fat, 



Hiole Grain. 


Fine Flour 


156 lbs. 


130 lbs. 


170 " 


60 " 


28 « 


20 " 



354 lbs. 210 lbs. 

Accordingly, the whole grain is one-half more nutritious 
than fine flour.* It also shows the very great proportion 
of hone material^ — that is, earthy constituents, — contained in 
the bran : no less than 700, out of a thousand parts, or a 
little more than two-thirds of the whole. Now, by reference 
to the same work, we find, in a communication from a Mr. 
Bentz, the difference in weight of a barrel of flour, without 
the bran, and when only the outer coating of the wheat is 
taken off. He says, " The weight of the bran or outer 
coating would, therefore, in the common superfine flour, 
constitute the offal, weighing only 5 J lbs. to the barrel of 
flour, whilst the ordinary weight of offal is from 65 to 70 
lbs. to each barrel of flour ; showing a gain of from 59f to 
65 lbs. of wheat in every barrel of flour." Now, if we 
estimate the earthy constituents to be two-thirds of the 
offal or bran, we must consider that there is an actual loss 
of these important constituents, which might be reserved, 
in every barrel of flour, of 40 lbs. 

Again, if we estimate, (according to the average of the 
consumption of flour to the amount of population, as one 
barrel to each individual,) that every child shall consume 
annually only half a barrel of flour, then we find, that by 
the use of the superfine flour, as commonly used in fami- 
lies, the child is deprived yearly of twenty lbs. of those 
earthy substances which are required to form the bones and 
the teeth. When we speak of a child consuming half a 
barrel of flour annually, it appears a large quantity ; but 
when we reduce the same to a daily allowance, we find 
that it is little more than 4 oz. or 4J oz. ; and every parent 
must know that this would be a very small amount to 
limit children. Yet we see how large a quantity of the 

* Patent Office Report, 1S47, p. 116. 



DR. PAUL'S ADDRESS. 23 

bony material would be added, if unbolted flour was used 
instead of the present superfine flour. I may here add, 
that the oatmeal used in Scotland, already referred to, con- 
tains the bran or inorganic constituents, while the oatmeal 
used in England is deprived of it. Now this is a great loss 
of the most valuable constituents in only one of the prin- 
cipal articles of the food of children ; and if we allude to 
another article, which is largely used on this continent, — ■ 
I mean Indian corn, — (and I may also add the fat of meat, 
both of which, children, if allowed, will partake of very 
freely,) we shall find that both of these abound more in the 
calorifacient, or heat-sustaining principle, and for the de- 
position of fat, than the nutrient ; and that they are quite 
deficient of the earthy material of lime — that material on 
which so much depends the proper structure of the teeth. 
Analysis of Indian corn shows the following composition — 
as taken from Mr. Salisbury's prize essay — read at the New 
York Agricultural Society, for 1849 : — 



Whole kernel. Ash of the kernel constituting about two 

per cent. 

Starch, ..... 50.64 Carbonic acid, ... a trace. 

1.450 
0.206 

50.955 
4.355 
0.150 

16.530 
8.286 

10.908 
0.249 
3.400 



Sugar and Extractive, . 7.46 Silicic 

Sugar ..... 1.50 Sulphuric " 

Fibre, *. 6.28 Phosphoric acid, 

Matter separated from Fibre, . 0.05 Phosphate of Iron, 

Albumen, .... 8.64 Lime, 

Caseine, .... 1.70 Magnesia, 

Gluten, .... 4.56 Potash, . 

Oil, 4.00 Soda, 

Dextrine or Gum, . . 4.84 Chloride of Soda, 

Water, ..... 10.22 Organic acid, 



99.89 97.000 

This is a most elaborate analysis — far more minute than 
any analysis we have had of any of the articles of food — 
in fact, more minute than satisfactory; for the analysis of 
the whole kernel does not exhibit any amount of inor- 
ganic constituent; and when the whole was converted 
into ashes, we find that the lime only amounts to the one- 
sixth of one part in a hundred. Now, on inquiry, I find,, 
on the authority of a very intelligent miller of this city, 



24 dr. paul's address. 

that in grinding corn, the bran, or thin skin of the grain, 
is detained in forming it into corn-meal; consequently, 
it is deprived of even that portion more particularly con- 
taining the earthy constituents. This gentleman in con- 
versation mentioned an important fact, relative to this 
deficiency of lime in corn. To the best of my recol- 
lection, he observed, " This stands to reason ; for r ten 
years ago, all the lower part of Jersey grew excellent corn, 
but would not grow wheat ; but since the introduction of 
lime as a manure, they have raised considerable wheat 
crops." Now the fact is, it is not the habit or food of this 
plant, even had lime been in the earth ; and magnesia and 
the saline manures are recommended to the agriculturist as 
best suited for its proper development. 

It is generally looked upon as invidious, and one is 
more likely to incur odium, than to receive credit for saying 
one word against a food which stands so high in public 
estimation, and is so universally used over this continent. 
Yet it must not, for one moment, be supposed that I con- 
demn the use of Indian corn, in its various forms of mush, 
hominy, bread, or pudding, as an article of diet — far from 
it; but containing, as it does, a large proportion of starch 
and fatty matter, rather a small proportion of the nutrient 
principle, and quite a deficiency of the inorganic or earthy 
constituents, I consider it as valuable, as a light diet, for 
heat-sustaining purposes only, and therefore a desirable 
adjunct to other food, containing more nutriment and a due 
proportion of the earthy constituents. 

As an example or illustration of the want of the nutrient 
principle in corn or corn-meal, I may here allude to the 
effects I have seen in the West Indies ; where, in a dearth 
of the ordinary provisions 'on which prisoners were fed, 
corn-meal was substituted; corn-meal and salted herrings, 
fish, &c, constituting their food. Now the effect was, that 
all the prisoners lost their natural strength; at the same 
time, they became fat and bloated, inclining to dropsy : 
and this was not the effect of incarceration; for the pri- 



DR. PAUL'S ADDRESS. 25 

s oners were engaged in road-making, trimming fences, &c. ; 
consequently, in a healthy and exhilarating employment. 

In reference to our domesticated animals, it may be 
asked, Why is corn so useful, as an article of food, to ani- 
mals generally — horses, hogs, sheep, &c. ? I have already 
shown that the overplus of the calorifacient food, after 
what may be required for sustaining the temperature, is 
stored away in the form of fat. Now, if we instance the 
horse : corn is generally, if not always, given as an ad- 
junct to his more usual food, hay. And we find by ana- 
lysis, that grass or hay contains not only the nutrient 
principle, but the inorganic constituents required in the 
formation of bone, &c. 

One hundred parts of dried hay contain — 

Carbon, 45.8 

Hydrogen, . . . 5.0 

Oxygen, 3S.7 

Nitrogen,* .... 1.5 

Ashes,t 9.0 

100 

Thus, the hay gives to the animal strength in bone and 
muscle, while the corn supplies additional heat-sustaining 
properties, and lays by, in the form of fat, the overplus as 
a reserve. The harder the horse is worked, the more corn 
he can bear ; the great proportion of the carbon being 
carried oil by the lungs, and the hydrogen and oxygen, as 
water, in exhalation and perspiration. But if the same 
quantity is given to a horse at rest, it overloads him with 
fat, which, in his case, accumulates more internally, or 
around the internal organs, and will, in course of time, 
induce disease ; while in the pig, under similar circum- 
stances, the fat is laid on externally, if I may so speak, 
giving the rich fat pork of our markets. And here I would 
again remark, that no farmer would consider it necessary 
or essential to give corn to a young colt or horse, until re- 



* Fifteen pounds of such hay, containing oz. 3.095 of nitrogen, 
t These ashes having a good proportion of lime. 



26 dr. Paul's address. 

quired to work; nay, so careful is nature, in appropriating 
just so much and no more of any constituent that may 
be required, that the food of the young horse should be 
more nutritious than heat-sustaining; and that there shall 
be no superfluity to store away fat, we find by analysis, 
that the milk of the mare has little or no butter, in fact 
only traces of it, in its composition.* What a lesson in the 
animal economy is here given, and what a practical illus- 
tration of the requirements of the young of that and other 
animals ! 

Again, it may be contended, that among the beautiful 
children we see on every hand, there is no want of those 
who are fat and hearty. It is not fat we want — it is bone 
and muscle — with so much fat only as shall give firmness 
to the flesh and plumpness to the figure. Fat, although it 
enters intimately into union with the other component 
parts of bone and muscle, cannot be transformed either into 
the inorganic constituents of bone or teeth, or into mus- 
cular fibre ; these must be contained in the food consumed, 
in the first place, and thence transferred to the blood. 

How necessary, then — how important it is — if we expect 
to give strength and vigor to the constitution, that the 
food, in the first years of infancy and childhood, when the 
formative process is going on, should receive some further 
attention than has hitherto been given to it ; and if our 
youth — if our young females have hitherto been deprived 
of the necessary constituents for the full development of 
every portion of the body — can we wonder that a woman 
should be the delicate and fragile being she is, or that by 
the decay which assails the teeth in early life, she should 
be deprived of an ornament of so much value? If this 
state of things can be altered — if the physical constitution 
of woman in America can be saved from further degene- 

* ANALYSIS OF MARE'S MILK. 

Water, 896.3 

Butter, ......... Traces. 

Caseine, ......... 16.2 

Sugar of Milk, Extractive Matters, and Fixed Salts, . 87.5 

1000 



DR. garrison's essay. 27 

racy — a purpose may be effected, of consequence even in a 
national point of view ; for it is to the healthy and vigorous 
constitution of woman that we must look for a race of hardy, 
vigorous and enterprising freemen. 

In conclusion, I would briefly state, that this is a matter 
in which professional aid can avail little ; it lies at the 
door, and must be the work of parents generally. It is 
for them to understand the great value to be attached to 
the food on which their children subsist — that it shall be 
wholesome and nutritious, and abounding in the earthy 
compounds so absolutely necessary to their proper develop- 
ment. If the chief articles of food have hitherto consisted 
of compounds made of superfine flour, corn-meal, and the 
fat of meat, let there be substituted in their stead, bran- 
bread, milk, eggs, the lean of meat, and potatoes ; let more 
attention be given to the nutrient quality of the food ; — 
let there be no deficiency of those articles containing the 
earthy material, that the bones and teeth shall not be defi- 
cient in those constituents so necessary in their composition 
and structure ; and I should be inclined to hope that the 
evils which now exist will be lessened, and the physical 
organization of succeeding generations be equal to that of 
any nation upon earth. 



DISTRICT MEDICAL SOCIETY FOR THE COUNTY OF 

GLOUCESTER. 



ESSAY 
ON PERIODIC OR RECURRING COLICS. 

Read before the District Medical Society for the County of Gloucester, by 
Joseph F. Garrison, M.D. 

We are constantly called upon to prescribe for persons 
suffering from the frequent recurrence of attacks of colic. 
Every few days or weeks they are tormented by the re- 
turns of paroxysms of disease — always painful — often dan- 
gerous — and sometimes so agonizing as to make them 



26 dr. Paul's address. 

quired to work ; nay, so careful is nature, in appropriating 
just so much and no more of any constituent that may 
be required, that the food of the young horse should be 
more nutritious than heat-sustaining; and that there shall 
be no superfluity to store away fat, we find by analysis, 
that the milk of the mare has little or no butter, in fact 
only traces of it, in its composition.* What a lesson in the 
animal economy is here given, and what a practical illus- 
tration of the requirements of the young of that and other 
animals ! 

Again, it may be contended, that among the beautiful 
children we see on every hand, there is no want of those 
who are fat and hearty. It is not fat we want— it is bone 
and muscle — with so much fat only as shall give firmness 
to the flesh and plumpness to the figure. Fat, although it 
enters intimately into union with the other component 
parts of bone and muscle, cannot be transformed either into 
the inorganic constituents of bone or teeth, or into mus- 
cular fibre ; these must be contained in the food consumed, 
in the first place, and thence transferred to the blood. 

How necessary, then — how important it is — if we expect 
to give strength and vigor to the constitution, that the 
food, in the first years of infancy and childhood, when the 
formative process is going on, should receive some further 
attention than has hitherto been given to it ; and if our 
youth — if our young females have hitherto been deprived 
of the necessary constituents for the full development of 
every portion of the body — can we wonder that a woman 
should be the delicate and fragile being she is, or that by 
the decay which assails the teeth in early life, she should 
be deprived of an ornament of so much value? If this 
state of things can be altered — if the physical constitution 
of woman in America can be saved from further degene- 

* ANALYSIS OF MARE'S MILK. 

Water, 896.3 

Butter, Traces. 

Caseine, ......... 16.2 

Sugar of Milk, Extractive Matters, and Fixed Salts, . 87.5 

1000 



DR. garrison's essay. 27 

racy — a purpose may be effected, of consequence even in a 
national point of view ; for it is to the healthy and vigorous 
constitution of woman that we must look for a race of hardy, 
vigorous and enterprising freemen. 

In conclusion, I would briefly state, that this is a matter 
in which professional aid can avail little ; it lies at the 
door, and must be the work of parents generally. It is 
for them to understand the great value to be attached to 
the food on which their children subsist — that it shall be 
wholesome and nutritious, and abounding in the earthy 
compounds so absolutely necessary to their proper develop- 
ment. If the chief articles of food have hitherto consisted 
of compounds made of superfine flour, corn-meal, and the 
fat of meat, let there be substituted in their stead, bran- 
bread, milk, eggs, the lean of meat, and potatoes ; let more 
attention be given to the nutrient quality of the food ; — 
let there be no deficiency of those articles containing the 
earthy material, that the bones and teeth shall not be defi- 
cient in those constituents so necessary in their composition 
and structure ; and I should be inclined to hope that the 
evils which now exist will be lessened, and the physical 
organization of succeeding generations be equal to that of 
any nation upon earth. 



DISTKICT MEDICAL SOCIETY FOR THE COUNTY OF 

GLOUCESTER. 



ESSAY 
ON PERIODIC OR RECURRING COLICS. 

Read before the District Medical Society for the County of Gloucester, by 
Joseph F. Garrison, M.D. 

We are constantly called upon to prescribe for persons 
suffering from the frequent recurrence of attacks of colic. 
Every few days or weeks they are tormented by the re- 
turns of paroxysms of disease — always painful — often dan- 
gerous — and sometimes so agonizing as to make them 



30 DR. garrison's essay. 

stipation ; or, as these states alternate, the gases of the 
bowel, which are often eliminated in very large quantities 
by the chemical reaction of the depraved secretions and 
unsuitable ingestse, are forced from one portion of the bowels 
to another, and expelled by the mouth or per anum ; or 
the irritation may even be so intense, that the peristaltic 
action is entirely inverted, and we have stercoraceous vom- 
iting ; or the spinal system may finally become involved, 
and we then have cramps of the muscles of the abdomen 
or limbs. 

This I conceive to be the rationale of the production of 
colic. When to this we have added a state of congestion 
or vascular irritation in the substance of any one of the 
tissues, as the cause of the attack, or quickly following 
the action of the cause, we may expect inflammation to 
be rapidly developed, which will be rendered violent and 
unmanageable by the excess of nervous action with which 
it is associated ; this, in its highest grade, is what is known 
as bilious colic, or ileus, and is generally the only danger 
we have to fear in managing the paroxysm of colic, as 
death from spasm or intensity of the pain is of very rare 
occurrence. 

It is more difficult to account for the mode in which 
colica pictonum is induced; but many circumstances seem 
to indicate that the lead has been absorbed into the circu- 
lation, and conveyed by the blood-vessels directly to the 
nerve-centres — first to the abdominal sympathetic centres 
— thus disturbing the power which regulates the sensations 
and peristaltic action of the bowels, producing pain and 
constipation ; and then on the spinal centres, which regu- 
late the motions of the arms, producing paralysis of their 
extensors, and flying pains over the whole system. That 
it is absorbed into the blood, and does not act by mere con- 
tact with the bowels, or mere nervous sympathy, is shown 
by the facts — that the most easily soluble salts are most 
poisonous — that it is most deleterious when inhaled into 
the lungs, where it is brought into direct contact with the 



DR. garrison's essay. 31 

blood — and that it is in almost every case preceded by the 
deposit of a compound of lead along the edge of the gums, 
forming that blue line which is so beautifully diagnostic 
of the disease, and which seems to show conclusively that 
the poison has entered into the circulation. We attend- 
ed, a few months since, a gentleman suffering from well- 
developed lead colic, caused by drinking water conveyed in 
leaden pipes. On looking at his gums, we found this blue 
line strongly marked. Some others of the family were 
complaining of uncomfortable feelings, but with no decided 
symptoms of the colic, and as they had all drank of the 
same water, we examined their gums and found the blue 
line clearly visible, indicating that some of the lead had 
entered the system, but not yet in sufficient quantity to pro- 
duce its characteristic phenomena. By ceasing the use of 
the water the blue line disappeared, and the impending at- 
tack was warded off. 

We have still a third class of colics ; that in which they 
are associated with some obstruction in the bowels, as im- 
pacted faeces, or a tumor, or with some organic lesion of the 
bowels, or a disease of some of the neighboring organs, as 
the liver or kidneys ; any of which may transmit an irrita- 
tion to the nerve-centres, which shall be reflected to the 
bowels and cause colic. In cases where colic is induced by 
such causes, it will of course be likely to recur frequently, 
so long as the disease which is the occasion of it shall con- 
tinue ; and the prevention of the colic can only be sought 
in the use of extreme care to avoid exciting causes, and en- 
deavors to remove the predisposing disease, which is too 
often an almost hopeless effort.* But by far the greater 



* A curious case of colic, referable to this class, fell under my notice some 
time since. The patient was an elderly lady who had been ill for some months. 
She had, at the hrst, nausea and vomiting almost incessantly ; these were all her 
complaint. She had no pain, no soreness, no fever, tongue slightly furred, no 
appetite, complexion straw color, countenance anxious, losing flesh rapidly, urine 
pale, of a peculiar disagreeable odor, depositing a copious pink sediment, which 
Prout says is one of the most certain signs, when present, of deep-seated disease 
of the liver. After a time, she had pain come on in the back, which soon be- 
come persistent over the region of the kidneys; this soon diminished, and was 



32 dr. garrison's essay. 

number of the cases of recurring colic seem to be the result 
of those causes which we have before indicated as the con- 
ditions favorable to the production of pain in the bowels : 
" Congestion of, or chronic inflammatory action in some of 
its coats, an alteration in the quantity or quality of the bile, 
or a depraved state of the intestinal secretions, which render 
them incapable of acting properly on certain articles of 
diet." So long as these conditions are present, a slight 
excitant, either internal or external, may cause a paroxysm 
of colic, which, being frequently repeated, constitutes the 
disease which we have called "recurring or habitual colics." 
In some instances, the morbid state which predisposes to 
the colic is too slight to affect the whole system, or even 
to excite, in ordinary, any strongly-marked local symptoms ; 
and the patient, in the intervals, feels quite comfortable, 
though seldom, we suspect, entirely free from all morbid 
sensation. But if the disease is allowed to continue, not 
only do the colics become more frequent and severe, but 
the slow and constant action of these causes at length de- 
velops well-marked disorder in one or all of the functions of 
the digestive apparatus; in other cases, symptoms of exten- 
sive derangement of this apparatus precede for some time 
the appearance of the colicky attacks. But whether one or 
the other of these states be that in which we find the patient 
to whom we are called to prescribe for recurring colics, the 
inference is, that some one of the conditions before named 
exists within the bowel, waiting only for an excitant to de- 
velop a paroxysm of pain ; and the indication is to correct 
these depraved intestinal secretions, or remove that chronic 
intestinal irritation which has predisposed to the attacks ; 
and the predisposition being thus removed, the excitants will 
no longer be able to develop an attack. 

The great agent in the correction of these deranged states 



followed by colic?, coming on every night after 12 o'clock, and accompanied with 
severe gravel : purges or opium would relieve them, but they regularly returned 
next night. After a time they left her again, but she shortly afterwards died, 
worn out by disease and debility. 



DR. garrison's essay. 33 

of the bowels is, as we all know, mercury; and it is in 
the steady ', long -continued, uninterrupted use of this mineral, 
in very small doses, and always short of salivation, that we 
are to look for a change in those morbid actions which are 
the cause of these recurring colics. The use of this drug 
in ordinary cases of indigestion is so common, that we are 
accustomed to regard it as our sheet-anchor in that disease ; 
but the idea of employing it in these cases of habitual colics, 
in this manner, and with the purpose of overcoming the dis- 
position to a return of the paroxysm, I have derived from 
my father, and, so far as my information extends, it is en- 
tirely new with him; he has thus used it for many years, 
and with very encouraging, though, of course, not invariable 
success. There is a peculiarity in the action of small and 
long -continued doses of some remedies — mercury, in parti- 
cular — different from that which they exercise when rapidly 
urged and in large amounts, which is very remarkable, and 
worthy of all note from the practicing physician : it is well 
illustrated in many instances of this disease, as will be 
noticed in the cases which I shall give of the details of the 
treatment. Dr. Latham, in his most admirable work on 
diseases of the heart, comments on it so judiciously, that I 
will quote his remarks. " Small bleedings and small doses 
of mercury are undoubtedly curative in forms of disease 
where large bleedings and large doses exercise no remedial 
power whatever ; a large venesection will, as it were, leap 
over the disease without touching it, and afterwards a few 
leeches will bring it safely and gradually to an end ; a 
rapid salivation will pass by the disease and leave it unal- 
tered; but when this salivation has been allowed to wear 
itself out, and the constitution being left to forget, as it 
were, the impression, and recover from it, then the remedy, 
being resumed on other terms and administered in very 
small and very cautious doses, has wrought, in process of 
time, an easy and an effectual cure.'' 

It is of this effect of mercury that we seek to avail ourselves 
in these cases — avoiding salivation as useless and likely to 
VOL. iv. — 3 



34 be. garrison's essay, 

interfere with the treatment — avoiding any irritation from 
the medicine by combining with it opium or cicuta, taking 
special care to keep the bowels calm by the use of mild in- 
gestce; and to avoid everything which would be likely to 
act as an irritant to the intestinal nerves — " cold, costive- 
ness, or improper articles of diet"— -neutralizing the action 
of the too acid secretions by the use of alkalis — obviating 
the tendency to constipation by the use of some light ape- 
rient, as the "blue mass, rhubarb and aloes pill;" or, what 
will often answer still better, in cases where there is rather 
debility than excitement, five grs. of sub. carb, of iron, with 
two grs. of rhubarb or aloes, three times a-day ; and treating 
any troublesome symptoms as they rise according to the in- 
dications; but persevering slowly and steadily in the use 
of the mercury, hoping, by a cautious continuance of it, to 
reduce the latent irritation, or to change the depraved se- 
cretions which have been the cause of all the evil, and keep- 
ing in mind the disposition so strongly marked in the ner- 
vous system, to be easily and frequently affected by causes 
which have once made an impression upon it, and not sus- 
pending our medication until the attacks have ceased for so 
long a time that the nervous system has lost its tendency 
to be so readily excited by impressions from a formerly dis- 
ordered organ. To illustrate the course of the disease in 
different individuals, and the mode of treatment, I will add, 
from my father's notes, and my own, the details of a few 
cases. 

Case 1. (From my father's notes.) " Called, January 29, 

1826, to see Mrs. H in an attack of colic. She was 

soon relieved by ordinary treatment ; but after her recovery 
from the paroxysm, she informed me that she had been sub- 
ject to returns of the disease at intervals of three or four 
weeks during the last two or three years ; and that, in se- 
veral of them, her life had been endangered by subsequent 
attacks of enteritis. She wished to be permanently rid of 
the colics. I proposed mercurial salivation, but she objected, 
as she had several times been salivated by a single dose, 



DR. garrison's essay. 35 

but never with any relief. I then advised one-quarter of 
a grain of calomel, with opium, three times a-day, with 
strict rules as to diet. She continued this until June ; 
during this time she had two or three very severe attacks. 
In June I stopped the treatment, fearing that I had done 
her no good ; — but she had no more attacks so long as she 
remained under my observation, five or six years. Her 
mouth was at no time affected by the mercury." 

In this instance, the colic seemed the only ailment of the 
patient. In the intervals, she was free from any con- 
siderable uneasiness, but there was, doubtless, a persistent 
derangement of the secretions of the intestinal canal, or of 
the liver, which was constantly predisposing her to the 
colics. We have many examples, in other parts of the 
system, where a fixed cause is productive of only paroxysmal 
developments of disease — as in cases where a persisting 
cause of irritation in the brain induces epileptic seizures at 
long intervals — or where a carious tooth excites only occa- 
sional hemicrania. 

Case 2. (From my father's notes.) " Called to prescribe 
for a member of Mr. Jacob Ballenger's family in August, 
1827. After having made my prescription, was asked in 
to see Mr. B., who had been suffering from colics for four 
or five years ; and so severely, that although previously a 
healthy and temperate man, he had two years ago given 
up his trade of wheelright, sold out his stock, and taken 
to his bed to die, as he expressed it, without any care on 
his mind. He had been several times treated for his dis- 
ease, by practitioners both regular and empirical. He had 
been rigidly dieted more than once, for several months in 
succession, and two or three times salivated severely — 
though it took large doses of mercury to affect his system ; 
but all with so little benefit, that he had relinquished all 
treatment and all hope of cure. He was now emaciated 
to the last degree — lay constantly on his back, with his 
knees drawn up, until sores had formed on the sacrum — a 
new cause of irritation. He had, during the last year, 



36 dr. garrison's essay. 

been constantly and severely affected with dyspeptic symp- 
toms ; vomiting all his food in an hour or two after it was 
swallowed, mingled with a quantity of acid matters, and 
sometimes clear bile. He was troubled excessively with 
flatulence and loud borborygmus — his eye was large and 
bright — his brow corrugated, as one suffering intense pain 
— his bowels were habitually constipated, and could only 
be moved by enormous quantities of medicine ; and the 
least quantity of opium added greatly to his sufferings from 
this cause ; but he was entirely free from the hypochon- 
driacal symptoms so common in cases of indigestion, and 
he retained medicines at all times — even the most nauseous 
— though rejecting all kinds of nutriment. He had pain 
in one shoulder, but no tenderness over the liver ; pulse one 
hundred and fifteen, and very weak ; skin dry and parched. 
His colics were now returning with exceeding violence, 
every ten or twelve days. The only food which his sto- 
mach had retained for some time, was a piece of cold pork, 
covered with black pepper, which he had taken the day 
before my visit. He was willing to undergo any treatment 
which promised him even relief — excepting mercury and 
opium; the latter induced such severe constipation, that 
he preferred suffering the colics to taking it ; and the mer- 
cury he thought had been sufficiently tried. I ordered 
him to continue the pork for his diet, with lime-water and 
cream; this relieved his more urgent symptoms — as sick- 
ness, &c. — and, in a few days, I commenced to give him, 
every four hours, two grains of pulv. cicuta, with one-eighth 
of a grain of calomel. He had two very severe attacks of 
colic within eighteen days ; after this, they were farther 
apart and lighter, and his bowels were more easily moved. 
He continued the medicine thus — only increasing the 
cicuta as the system became habituated to its use — during 
which time, milk and old bread were added to his diet and 
retained. Under the treatment, he improved, and stopped 
it in December ; but another attack, in January, induced 
a return to the course. The calomel was then increased 



DR. garrison's essay. 37 

to one-quarter of a grain, and continued another month, 
when, having had no attack, he ceased the calomel, and I 
substituted the nitro-muriatic acid; from this time onward, 
he recruited rapidly, recovered his former health, and till 
he passed from my notice, seven years subsequently, had 
no farther attacks." 

In this case, the attacks of colic preceded some two years 
the full development of the symptoms which in the end 
told, in the most distressing manner, the disastrous in- 
fluence of even a slight deranging cause, if allowed to go 
on unchecked ; the altered secretions, whose existence was 
shown at first only by the occasional colics, soon disor- 
dered in an extraordinary degree all the digestive appa- 
ratus. 

My father has used the remedy, in cases similar to those 
just quoted, ever since that time ; and of some fifteen or 
twenty thus treated, all but five have been permanently 
relieved; and in those five, relief was afforded — but only 
temporarily, as the disease returned at periods of three, 
five, and six years. 

Case 3. (From my own notes.) Called, September, 1846, 

to prescribe in an attack of indigestion for Mrs. P , 

about thirty years of age, the mother of several children, 
and hitherto in good health. She w r as soon relieved of the 
most distressing symptoms, but was seized, in a few days, 
by a terrific attack of colic — which was, in a short time, 
followed rapidly by others, some of exceeding violence, from 
which she was with difficulty relieved. Her health began 
rapidly to sink, from the influence of the suffering induced 
by these repeated attacks, and the dyspeptic symptoms 
now constantly present ; her spirits were depressed ; her 
countenance sallow ; her eyes sunken, with blue discolor- 
ation beneath them ; hands and feet, particularly the latter, 
constantly cold, with sensations of chilliness over the whole 
body and across the abdomen. After eating even the sim- 
plest article, as bread, she experienced feeling of tightness 
and Oppression at the epigastrium. She had constant sore- 



38 DR. garrison's essay. 

ness of the abdomen, with disposition to tympanitis, borbo- 
rygmus and belching. The tongue was covered with a thin 
white gauze-like coating ; the bowels were always costive ; 
but unless they were freely open every day she had violent 
pains. After several of the attacks she was threatened with 
enteritis. At length the paroxysms grew so frequent and 
violent that she consented to a regular course of treatment. 
I commenced by giving two-thirds of a grain of calomel 
in the day, in divided doses, with three or four grains per 
day of Dover's pulv., and at bedtime three or four of the 
blue mass, rhubarb and aloes pill, to obviate the costiveness. 
But after a few days I substituted, in place of these, a 
powder, taken three times a-day, (each containing sub carb. 
of iron, gr. v; and powdered aloes, gr. i vel. ij), which 
answered admirably, producing, at the same time, a tonic 
and an aperient action. I continued the calomel, as above, 
eight weeks, and then increased it to gr. iss a-day. She 
amended rapidly under the treatment, and had no more 
colics, although several times threatened, from violations of 
the strict dietetic rules which were necessary. At the end 
of the third month, she had so far improved as to suspend 
any further treatment, and has since continued free from 
her colics. A short time before this, I treated another lady, 
somewhat similarly affected, who continued undisturbed 
until the past winter, during which she has had an attack, 
about three years from her last one. 

The last case cited is an instance where the symptoms 
of intestinal derangement preceded the colics, and were 
fully developed before the coming on of the paroxysms. 

Each case is the type of a class ; differing, however, 
mainly in the order of sequence of the phenomena, and not 
so much in their nature ; similar as to the essential cause 
of the colics : similar as to the main outlines of the treat- 
ment, but requiring, as does every case which comes under 
the care of a physician, the use of discrimination and tact, 
in meeting the indications and in the adaptation of the great 
remedial agents to the particular exigencies of the occasion. 



MORAN ON HYDROPHOBIA. 39 

ON THE TREATMENT OF HYDROPHOBIA. 

BY FRANCIS MORAN, M. B. 

I send you a statement of the following eases of persons 
bitten by dogs undoubtedly rabid, which, if you think it 
worthy of an insertion in your journal, you are at liberty 
to publish. Some of these persons were bitten on the bare 
skin — others through very thin clothes ; the first through 
pantaloons ; but as he was severely bitten, it was supposed 
that much danger existed ; still, the nature of clothing 
was explained to him and to the others, and the possibility 
of an abraded surface escaping from infection from the 
virus. In none of the cases do I regret the means used ; 
for in such cases the mind needs something to feed upon, 
as also that of the community. Still, though we should 
make use of the best means to prevent the disease of 
hydrophobia, and keep the mind tranquil, we should never 
do it at the sacrifice of truth. In regard to the use of the 
sub-acetate of copper, I was induced to use it, as it was 
the active part of the remedy of John M. Grouse, of New 
York ; but only in proper doses. As the late Dr. David 
Hosack recommended it, as one of the best tonics he knew, 
from its effect in the fifth case, I feel warranted in adding 
my testimony (small though it is) to his. I would, how- 
ever, candidly state, that the removal of the bitten part, 
when it can be done, and at any time before the appear- 
ance of disease there, is the only remedy in which I have 
any confidence ; all others are merely auxiliaries. They 
act on the mind ; and in the prostration which the fear of 
the disease produces, tonics, and medicines which will allay 
the nervous excitement, are needed. 

I had been engaged in the study and practice of medicine 
and surgery eighteen years, without a case of actual or 
dreaded hydrophobia ; when, on the night of the 12th of 
November, 1835, I was called on by a resident of this town- 
ship, who stated that his brother, R. Stockbower, was, two 



40 MORAN ON HYDROPHOBIA. 

or three days previously, bitten by a rabid dog ; that he had 
applied to Dr. Crittenden, of Dover, now deceased, who ad- 
vised him to return home as soon as possible, and get a phy- 
sician in his own place to attend him, but not to rest satisfied 
till he had the bitten part cut out clean ; he requested me to 
call on Dr. Hedges, then of this village, now deceased, and 
consult with him, and between us to do the best we could 
for the safety of his brother. I did so, and the result of our 
united opinions was, to remove the bitten parts, and then 
put him on the remedies stated below. I repaired to the 
house, before day, and removed seven pieces, to the best of 
my recollection ; applied simple cerate, with occasionally 
the green cerate to keep the parts discharging, for a month 
or more ; and gave, internally, the sub-acetate of copper, in 
doses which would be easily retained in the stomach, three 
times a-day, with a pretty strong infusion of Scutellaria. 
This treatment was followed for about a month : the man 
had no bad symptoms, and is now a healthy man. 

Case 2. Not long after — but I have kept no notes which 
would give me the precise time — J. Hindershot applied to 
me. He had been bitten on the hand ; the skin was 
abraded ; a similar treatment to the above was adopted. 

Case 3. 23d of June, 1836, Capt. M. Cox was bitten on 
the hand by his own dog. This dog, after biting him, 
passed over about three miles of road, and through the vil- 
lage of Lafayette, biting, or attempting to bite, every living 
thing which came in his way ; he was there killed and 
thrown into the creek. The captain hearing that a dog 
had been killed supposed to be his, to be satisfied of the 
fact, dragged the creek for several hours, till he found the 
body, which proved to be that of his own dog. He came to 
me, wet, weary and sad. I stated to him my former expe- 
rience, such as it was, and gave him as much hope as I 
honestly could. The piece was cut out ; the copper and 
scullcap was given, as in the other cases. This treatment 
was pursued for about a week or more, when a clergyman 
recommended an application to a physician in a neighboring 



M0RAN ON HYDROPHOBIA. 41 

county, who was said to possess a valuable remedy. This 
physician wrote a letter to me and Dr. Hedges, stating his 
remedy ; which was — 

R. — Mild chloride of mercury, grs. vj ; 
Hydrochloric acid, gtt. xij ; 
Alcohol, f. oz. iij. — -M. 
Commence with half a teaspoonful, to be increased to a 
whole one if the stomach will bear it, and continued till the 
system is brought under a mercurial influence ; this to be 
preceded by a dose of jalap and calomel, which is to be fol- 
lowed by a full dose of laudanum. 

By the advice of Dr. Hedges, this remedy was substi- 
tuted for the copper, which, with the scullcap, was con- 
tinued for about three weeks. By the use of this there 
was a slight ptyalism produced. My patient is still a hearty 
man. 

Case 4. About August of the same year, Mathers, 

of Westtown, Orange county, N. Y., came to Lafayette, on 
his way to Easton, Pa., to consult Dr. Saylor, a celebrated 
witch doctor and empiric. Several gentlemen of that village 
advised him to abandon his journey and to apply to me, 
which he did that day. He was bitten on the hand by his 
own dog, a day or two before. The dog he chained up at 
home. I cut out the piece ; gave him the cerates and copper 
pills, with the scullcap, as used in the former cases. He 
went home satisfied. On his return, however, finding that 
his dog died raving mad, and induced by the advice of 
officious persons, he rested not till he had seen Dr. Saylor, 
a distance of about seventy miles. But, being a man of 
considerable intelligence, finding that Saylor put him off 
with some nostrum, which he supposed could not reach his 
system as a remedial agent, he returned from him dissatis- 
fied ; and on his way home called again on me for some 
more scullcap, which I gave him. He promised to con- 
tinue my plan of treatment, and to advise his family, if any 
symptoms should show themselves like the approach of the 
disease, that they should immediately call on me ; and as I 



42 MORAN ON HYDROPHOBIA. 

have heard nothing of him since, though but a distance of 
twenty-four miles, I conclude he continued well. 

Case 5. October 3, 1840, a daughter of S. Ward was sent 
to me. She was a delicate child, of about eight years of 
age. She was bitten on the leg by a dog ; a single tooth 
appeared to have penetrated through a thin stocking and 
into the leg about a quarter of an inch. A physician had 
put some corrosive substance into the wound, which had 
(or else the tooth) produced a tumefaction in the part of 
about two inches in diameter. I removed the tumefied part, 
at the centre sufficiently deep to pass the knife some dis- 
tance below the part injured by the tooth ; and put her on the 
treatment pursued in most of the other cases, viz., simple 
and green cerates to the wound ; the copper and scullcap in- 
ternally. Upon this treatment the child appeared to acquire 
a new development of her frame, and renovation of her con- 
stitution, and from being a weak, feeble child, became a 
ruddy-cheeked girl; and, astonishingly to me, she became 
so attached to me, notwithstanding the apparent harshness 
of the operation of removing the piece in the tumefied and 
inflamed state in which it was, that for some years, when she 
came to our village, she would not be satisfied without calling 
to see me. She is now a promising young lady. 

I have now to record another case, which, from the care- 
lessness of the patient and parents, and from the inter- 
ference of a neighboring physician (a physician to whom 
Dr. Pennington once applied the epithet of Ishmaelite), gave 
me more trouble than all the others. 

Case 6. June 1, 1843, J. Groover, a lad of about thir- 
teen years of age, was bitten near the hip, through thin 
summer clothes, by a dog which had bitten several ani- 
mals (these animals all subsequently went mad). He was 
brought to me. The skin was abraded, but no appearance 
that blood had been drawn. I removed a piece of the 
skin ; put him on the mercurial course, as prescribed in the 
case of Captain Cox, in the form recommended in the pre- 
scription I had received as above stated — it being the same 
form nearly as given by Dr. F. W. Francis, for children — 



MORAN ON HYDROPHOBIA. 43 

with very strict directions, an*d promised to visit him occa- 
sionally ; but his brother wished me not to put them to 
that expense ; promising to inform me, should anything 
occur requiring my attendance. This case has given a 
useful lesson to me, never again to give medicine to a 
person who is unwilling to have the necessary attendance 
during its administration ; for they invariably complain 
most of want of attendance, if through their own care- 
lessness any untoward accident occurs. 

About the first of July, on an extremely hot day, he was 
brought to my house, in my absence, in a large open wagon, 
and word left to visit him the next day ; which I did. I 
found him with considerable fever, and a swelling on the 
side of the neck, and skin much flushed and red. I pre- 
scribed febrifuge medicine, and liniment to the neck. In 
two days, an abscess had formed on the neck, which I 
opened; then his skin showed an appearance very much 
resembling scarlatina. I was told by his mother, that pre- 
viously to his complaining, he had bathed in a pond near 
the house, which the lad denied; but he being of a high 
temper, and appearing to have had much of his own way, 
I rather inclined to favor the statement of the mother. I 
was subsequently better satisfied from the statements of 
several respectable persons, who had seen him bathe several 
times, that my decision was well formed. The physician 
above alluded to raised an alarm ; stated that I had given 
the lad poison, which had produced mercurial erythema, 
(although he had been on its use for a month, without 
producing any derangement, or even ptyalism), while it ap- 
peared to me that the fever and disease of the skin was 
produced by the locking-up of the surface by the baths, 
and subsequent exposure to the sun's rays, in traveling in 
an open wagon, about twelve miles, on a very hot day, 
with many other irritating causes. It is needless to detail 
the treatment of this new disease, which was on general 
principles. He got well as soon as could be expected, and 
is now in good health. 

Newton, Sussex Co., N. J. 



44 BUTLER ON LITHIASIS. 

HYDRANGEA ARBORESCENS: 
A NEW REMEDY IN LITHIASIS. 

BY S. W. BUTLER, M. D. 

One of the most severe complaints to which man is liable, 
causing perhaps more exquisite suffering than any other, is 
that in which solid amorphous and crystaline sediments are 
deposited in the kidneys or bladder. The complaint, how- 
ever, is so seldom met with, at least in this part of the 
country, that it is probable that little is known practically 
about it by most physicians. 

Yet, as we do occasionally meet with it, and as it is de- 
sirable that every physician be prepared to combat the dis- 
ease by every means which the God of Nature has placed 
within his reach, I have thought it best to prepare for pub- 
lication a short account of a new method of removing 
calculi from the kidneys and bladder, provided they are not 
too large to pass the urethra. 

As I merely propose a means of removing these deposits, 
after they have been already formed, I shall say nothing of 
the prophylactic measures that may be resorted to in the 
different diatheses; leaving this to the judgment of the 
practitioner, guided, if he pleases, by reference to the valu- 
able works of Prout, Bird, Brodie, &c, on the subject. Nor 
will I at present advert to the means proposed for the re- 
moval of the deposits when made, which are recommended 
by Cooper, Brodie, and others. What I particularly wish 
to call attention to in this paper, is the fact, that a remedy 
exists which has been successfully employed for removing 
calculi after they have been formed. The principal obser- 
vations that have been made on the remedy in question, 
have been by my father, Dr. E. Butler, who has for 
the last thirty years acted as a missionary of the A. B. C. 
F. M. among the Cherokee Indians ; in a part of the country, 
therefore, where sabulous and gravelly deposits are more 
frequently met with than among us. 



BUTLER ON LITHIASIS. 45 

The plant producing the remedy is very well known in 
the South and West by the name "seven barks;" and a 
species of the same plant is familiar to most persons as an 
ornamental garden shrub, under the name "hydrangea." 

Botanically, the plant yielding the remedy is known as 
"Hydrangea Arborescens." In the southern, middle, and 
western States, it grows abundantly "in the mountains 
and hills, and on rocks and near streams." I found it 
growing abundantly also on the banks of the Schuylkill, 
above Philadelphia ; and Mr. Durand, a botanist of Phila- 
delphia, informs me that he has seen it growing on the 
Bonaparte property at Bordentown. Whether or no it is 
to be found in other portions of the State, I cannot say. 
I know not that I can describe the plant so that it will 
be recognized by persons not familiar with its appear- 
ance. It is a perennial shrub, sending upwards nume- 
rous stalks from a caudex or head, to the height of from 
three to five feet. The bark is rough, peeling off — each 
layer being of a different color ; probably giving origin to 
the name "seven barks." The leaves and flowers much 
resemble those of the garden hydrangea. When green, 
the stalks and root contain much water, and the latter a 
great deal of mucilage, with albumen and starch ; but 
when dry they are very hard, and exceedingly difficult to 
bruise ; if used, therefore, they should be bruised while 
green. The stalks contain a pith which is easily removed, 
and they are used in some parts of the country for pipe- 
stems. 

For therapeutical purposes, my father has employed a 
simple decoction, or a syrup made from a decoction of the 
root, with sugar or honey. This was made of such a 
strength, as to be given in the dose of a teaspoonful three 
times a-day. In an over-dose, it produced some unpleasant 
symptoms, such as dizziness of the head, oppression of 
the chest, &c. The effect the remedy seems capable of 
producing is, removing by its own specific action on the 
bladder such deposits as may be contained in that viscus ; 



46 BUTLER ON LITHIASIS. 

provided they are small enough to pass the urethra. It 
has seemed also to have the power of relieving the excru- 
ciating pain attendant on the passage of a calculus through 
the ureter. Whether this is dependent on any anodyne 
property which the remedy may possess, or upon its action 
in removing the cause, by promoting the discharge of the 
calculus, I know not : but think most likely on the latter. 

The limited observations which have been made on this, 
as a therapeutical agent, will prevent me from claiming 
for it any more certain action than can be gathered from 
the following imperfect detail of cases. The object I have 
in view, is to call the attention of the profession to the re- 
medy, in the hope that those who may have the opportu- 
nity will try it, and if it proves successful in their hands, 
make it known to the profession, either through the medium 
of medical publications, or otherwise. 

In giving the following cases, it is but justice to the 
parties concerned, to say that not one of the patients lived 
within thirty miles of his medical adviser ; it was therefore 
impossible to make correct observations or to give perfect 
details. 

Case 1. Concerning this case my father writes me : — 
"When some thirty miles from home, I saw an old Indian 
doctor, named Rattling-gourd, in great distress with the 
gravel. I recommended to him a free use of the decoction 
of this plant. Some months afterwards I saw him again, 
and found he had used it, and not only found relief, but he 
said, ' It has cured me.' " 

Case 2. Miss Elizabeth J , being subject to attacks 

of gravel, applied to my father for relief. He recommended 
to her the use of the root of the hydrangea. She afterwards 
said to him — " I have been under the care of several phy- 
sicians belonging to the army, and taken many kinds of 
medicine for my complaint, but have found nothing to re- 
lieve me as the decoction of this plant has done." 

Case 3. S. Watts, a Cherokee farmer, aged forty, had 
suffered long and severely from the gravel. He finally sent 



BUTLER ON LITHIASIS. 47 

for my father, who supplied him with some of the syrup of 
hydrangea root. It gave him immediate relief from his 
suffering, and, after having used it for a few days, he passed 
about one hundred and thirty calculi, besides a large quan- 
tity of sand. A few of the calculi were lost ; the remainder 
are in the possession of my friend and late preceptor, Dr. 
John Neill, of Philadelphia. Being almost round, they have 
the appearance, in a vial, of so many pills of different size. 
The number and weight of them are as follow : — 

Whole number of calculi, . 120 

Weight of whole, . . 3 J drs. 

Average weight, . . . 1.75 grs. 

Weight of largest, . . 9 grs. 

The largest lodged in the fossa navicularis, and had to 
be removed by the aid of instruments. Twenty-seven of 
the calculi were passed within half an hour. Mr. Watts 
recovered entirely from the complaint. 

Case 4. Philip S. Swartley, farmer, aged about forty-five 
years. Had been suffering from calculi four or five years. 
Last winter he applied to Dr. Neill of Philadelphia, who 
furnished him with some of the syrup of hydrangea root 
which I had in my possession. The medicine relieved him 
of pain immediately, and he subsequently brought to Dr. N. 
two of several calculi he had passed under its influence 
soon after he began its use. The largest of these weighed 
eleven grains, and was nearly half an inch long. He also 
passed a great deal of sand. When I last heard of Mr. S. 
he had not had a return of his complaint, and was in the 
enjoyment of good health. 

If I judge correctly, the above cases, though imperfect, 
are sufficient to induce a trial of the remedy. 

Burlington, N. J., Aug. 1850. 



[Note. — The Hydrangea root may be obtained of Dillwyn & Edward Parrish, 
S. W. corner of Eighth and Arch Sts., Phila., who will give directions for a uni- 
form preparation of it.] , 



48 CHLOROFORM IN OBSTETRICS. 



CHLOROFORM IN OBSTETRICS. 

BY J. B. MUNN, M. D. 

Within the last few years much has been written, and 
much has been the experience of the medical profession in 
the United States and in Europe, upon the use of sulphuric 
ether, and more particularly chloroform, as a means of sus- 
pending muscular contraction and painful sensations in 
various surgical operations. 

The writer of this communication, so far as he has seen 
the effects of those agents in the hospitals of New York 
and Boston, and in private practice, in rendering patients 
insensible to pain during surgical operations, is bound to 
say that he has been highly gratified by the results he has 
witnessed, and has come to the conclusion that these 
agents, used judiciously, have already proved highly bene- 
ficial ; and their good effects, it is confidently believed, will 
hereafter be generally acknowledged, and hailed as great 
blessings, for the relief of the afflicted. 

Such has been, as yet, the difficulty of overcoming the 
prejudice against the use of chloroform in obstetric prac- 
tice in this country, that it has not been used here to much 
extent — it having been hitherto confined mainly to the 
cities and populous towns ; yet, so far as it has been tried, 
it has proved a useful means in painful and tedious labours. 
The reports from several of the medical profession I have 
conversed with on the subject, are very interesting and 
gratifying, and serve to show that by inhaling it moderately 
it lessens much of the distress in severe parturient cases, 
and relieves greatly, without inducing insensibility ; there- 
fore, with due care and skill, little or no danger is to be 
apprehended from its use. 

Does chloroform, when used, suspend or paralyze the 
propelling muscular contraction of the uterus, in the throes 
of labour ? The advocates for its use in midwifery say 
not ; but that the efficient uterine contraction of labour 



CHLOROFORM IN OBSTETRICS. 49 

propulsion progresses in a manner as if unaffected by the 
agent, notwithstanding its general action upon the system 
is to suspend muscular motion, and, to a great degree, all 
painful sensation. 

Will the effects of inhaling chloroform be to relax that 
uniform contraction of the uterus and its orifice upon the 
foetus, met with in arm presentation, after the liqua amnii 
has passed off, and no regular labor-pains present, when 
we are left only, as a last resort, to mutilate and deliver 
the foetus with the crotchet and blunt-hook, to save the life 
of the mother? Or will the use of it, under these circum- 
stances, save the sufferer from the operation of taking away 
the child by piecemeal, as it has been often called, from the 
consequences necessarily of more or less injury done to the 
soft parts; and from much delay, followed by pain, fever, 
and tedious recovery ? 

Perhaps the following case may serve the purpose of af- 
fording, not merely a conjecture but a fact, in answer to the 
above questions. 

On the 9th day of August, 1850, I was sent for to meet 
Dr. Kitchel, of Hanover, in consultation, and arrived at the 

place of meeting about three o'clock P. M. Mrs. S , 

thirty-eight years of age, of a robust constitution, and mo- 
ther of a family of eight children, was the patient. Dr. 
Kitchel informed me that she had had labor-pains during 
the previous night, and was seven months or more ad- 
vanced in pregnancy. At four o'clock in the morning the 
membranes had given way, and the liqua amnii had passed 
off entirely. He had arrived there three hours afterwards, 
and found the patient without labor-pains. An alarming 
hemorrhage had taken place before his arrival, but had 
ceased then. She was exhausted, pale, and fainting. 

Under the impression that it might be a case of placenta 

prasvia, as soon as prudently could be done, he proceeded to 

make a vaginal examination, and found the os uteri just 

sufficiently expanded to admit the ends of two fingers; 

vol. iv. — 4 



50 CHLOROFORM IN OBSTETRICS. 

it was thick and rigid. At the same time, the uterus was 
contracted firmly upon the foetus, and no labor-pains pre- 
sent, except a kind of resisting pain, which was felt upon 
examination. 

Another hemorrhage came on about eleven o'clock A. M., 
preceded by slight pains. The presentation not haying 
yet been made out, and the flooding continuing, it appeared 
necessary that something should be done immediately to 
save the patient. The hand was passed into the vagina 
to make a full examination, and such efforts as the case 
might seem to require; then it was that the hand and 
arm of the child were found presenting in the os uteri. 
Attempts were made, by pushing the arm back, to reach a 
foot; but on account of the rigid contraction, as above 
mentioned, it could not be done. In about fifteen minutes 
afterwards, the hemorrhage ceased entirely. After my 
arrival, renewed efforts were made to reach the inferior 
extremities of the foetus ; but they were soon found to be 
unavailing, as no part of the child could then be reached 
by any justifiable force (on account of the rigidity above 
stated), except the shoulder, axilla, and rib beneath it — 
and that after persevering efforts. 

Mrs. S., when undisturbed by examination, had no appa- 
rent pain, and was comfortable, although weak and pale. 
The last hemorrhage had been arrested by cold applica- 
tions, three hours before my arrival, and did not occur 
again. The locked contraction of the uterus remaining 
unchanged, we administered forty drops of laudanum, 
hoping that its relaxing effects would cause further dilata- 
tion of the os uteri; and advising repose and nourishment 
we left her undisturbed for some time. With the near 
approach of night, however, the lady began to be very im- 
patient ; calling upon us repeatedly for help, and begging us 
to use instruments, if we thought them necessary; so that 
our solicitude and anxiety became more and more excited 
to relieve her, as soon as we could obtain such available 
means as we wanted for the final efforts. 



CHLOROFORM IN OBSTETRICS. 51 

Accordingly, we sent to Morristown for chloroform, in- 
struments, and medical assistance. About nine o'clock in 
the evening, Dr. J. W. Canfield joined us ; when, in con- 
sultation, we decided first to try the effects of chloroform, 
in order to relax the rigid os uteri, as well as to suspend 
muscular contraction and pain. 

On examination, Dr. Canfield found the state of the 
case precisely as we had described it. Mrs. S., upon being 
informed that we intended to have her inhale chloroform, 
objected to its use, saying she wished to have her senses to 
the last. She was assured it should be used with due 
caution, and not pushed to the extent of inducing insensi- 
bility. As the shoulder and head of the child were on the 
right side of the patient, the left hand was introduced into 
the vagina by Dr. Canfield, to pass it, if practicable, into 
the left side of the womb. He found it, however, so rigid 
and contracted, that the ends of the fingers were with 
some difficulty pressed a little within the mouth of the 
womb. Mrs. S. having begun by this time to experience 
the agreeable effects of the chloroform, asked for more. 
After inhaling it for a short time, the fingers, by a mode- 
rate effort, were passed into the uterus as far as the 
knuckles. Resting for a minute or less, and the relaxation 
increasing, the hand was easily pushed forward, and came 
immediately in contact with a foot, which, being firmly 
grasped, was drawn down into the vagina. The foetus was 
now delivered without delay or difficulty ; and the placenta 
followed quickly. 

The time occupied in the use of the chloroform and de- 
livery was not more than half an hour. The recovery 
afterwards was every way favorable, and no medical at- 
tendance required, except a call or two, made when the 
family physician was in the neighborhood. 

Chatham, Morris Co., N. J. 
Sept. 19, 1850. 



52 MEDICAL CURIOSITIES. 

MEDICAL CURIOSITIES. 

BY THE EDITOR. 

A Crowing Child. — H. A. L is an exceedingly 

nervous, excitable person. Before her marriage she was 
frequently under my care for hysteria in a variety of forms. 
I attended her, about nine months since, in her first ac- 
couchement. Her labor was tedious, and very painful ; 
the child was of full size, and well-formed. There were 
no signs of life exhibited by the infant at the moment of its 
birth, but after spending half an hour in attempts to resus- 
citate it, respiration was fairly established. The mother 
recovered her usual health in a short time, and resumed her 
household duties ; but, to the astonishment of all who were 
interested in the case, the child did not cry. When P dis- 
continued my visits to the mother, it had not cried once. 
I called occasionally to watch it, and though for a short 
time it grew, and seemed to be in perfect health when about 
a fortnight old, it began to lose flesh, and became very fret- 
ful ; and though it took the breast well, its nourishment 
was generally rejected, in part or entirely, soon after it was 
received into the stomach. It would not lie on the bed, 
but required constant nursing. At times it appeared to 
suffer pain, and tried to cry ; but the effort to expire pro- 
duced a singular noise, which resembled very much the 
crowing of a young chicken. From the loss of rest, and 
almost incessant jactitation, it became quite emaciated, and 
the hope of recovery was very slender. I was not able to 
discover any organic affection of the respiratory organs ; the 
air entered the lungs without difficulty, and when the little 
patient was free from suffering, and perfectly at rest, they 
gave, upon percussion, a healthy, resonant sound. The dif- 
ficulty seemed to be in expiration, and that only when the 
effort was accelerated by the presence of pain, hunger, or 
other sensation which created the desire to cry. A variety 
of treatment was adopted in the case. Assafcetida, by the 



MEDICAL CURIOSITIES. 53 

mouth and per anum, was administered daily for some 
weeks. Musk, hyosciamus, valerian, and other nervous 
stimulants, in combination with remedies to correct the se- 
cretions of the digestive apparatus — as hyd. cum creta, 
calomel in small doses, sub nitrate of bismuth, &c, &c. — 
were all resorted to, but with no permanent benefit. Salt- 
bathing was also adopted for a time, and frictions upon the 
spine, with the oils of amber, cajeput, and olive, but with 
the same unsatisfactory results. At one time a small abscess 
formed on the throat externally, near the margin of the 
thyroid cartilage, which I hoped would be of service, but it 
discharged and disappeared without any apparent change. 
I finally put my patient, now reduced to a skeleton, distress- 
ing its parents day after day, and night after night, with 
its pitiful, crowing noise, under the use of alterative doses 
of calomel and extract of belladonna, which seemed to pro- 
duce a speedy change for the better: the child began to 
improve very soon after the commencement of this treat- 
ment, and is now robust and healthy. At this time the 
respiratory function is performed with less interruption than 
formerly, and the effort to cry produces a sound very much 
like a hurried, broken laugh: the crowing sound has dis- 
appeared. 

The history of this curious case is submitted to the 
reader without any attempt to explain its pathology. Dur- 
ing its progress, I have had so many conflicting suggestions 
presented to my mind as to its true cause, that I forbear to 
offer any of them, but will be glad to show to any of our 
friends who may call on us, the singular spectacle of a 
well-grown, healthy child, of nine months old, who has 
never cried. 

Rupture of a Sac in Utero, at the sixth month of preg- 
nancy. — A lady sent for me to see her, in a supposed mis- 
carriage at the sixth month. When I reached her, she 
gave me a history of her case, as follows. Ever since she 
discovered her situation, she had been sensible of an un~ 



54 MEDICAL CURIOSITIES. 

pleasant sensation in the right iliac region; it gradually 
became more acute, and within the last month had caused 
her severe pain at times. She was most frequently seized 
with pain at night, or whenever she was in a horizontal 
position ; and was unable to lie on the affected side. When 
the attacks came on, she was obliged to sit up, and resort 
to frictions with the hand, when the severity of the pain 
generally abated. About an hour before I saw her, she 
was awakened from her sleep with a sharp pain in the 
same side, a little higher up than usual, which she de- 
scribed as agonizing in the extreme for a few moments. 
She was, however, suddenly relieved by " something giving 
way," and a copious flow of water; at which moment she 
fainted. I suspected a premature labor, and made an ex- 
amination per vaginum. The anterior lip of the uterus 
was slightly elongated, and the os uteri, as I then thought, 
a very little dilated. She had not had pain since the jflow 
of water, but felt more comfortable than at any time before. 
I saw her repeatedly through the day, but there was no 
evidence of approaching labor. In a few days she was 
able to resume her former exercise. The liquid that was 
discharged was colorless and inodorous. As nearly as we 
could judge, there was at least a quart of it. Soon after 
its evacuation, a circumscribed space, occupying the seat 
of her former pain, was very perceptible, which gave a de- 
cided tympanitic sound on percussion, but was free from 
pain on pressure. This gradually disappeared, and my 
patient felt better than at any time before during her 
pregnancy. She could lie on her right side, and was re- 
lieved from the sense of pressure and fulness which she 
had previously experienced. The fact of there being but 
little pain while in the erect position, and its being increased 
by the horizontal position, when the gravitation of the 
uterus was in the direction upwards and backwards, and a 
hollow space being left after the discharge of fluid, consi- 
dered in connection with the sudden relief experienced at 
the time of the evacuation, would seem to justify the con- 



MEDICAL CURIOSITIES. 55 

elusion that an adventitious sac of some description was 
attached to the uterine walls. Was it not a hydatid ? 

Case of Annual Return of Cutaneous Poison. — A. L , 

a young lady, now twenty-two years, of age, was exposed, 
in the summer of 1838, to the acrid vapor of the rhus toxi- 
codendron, or poison oak. A smarting sensation in the face, 
occurring after washing with cold water, followed by redness 
and swelling, induced^ the belief that she was poisoned by 
the plant, which she had met with in her walks ; the subse- 
quent vesication, and desquamation of the cuticle, confirmed 
her suspicion. The treatment was palliative, and with the 
decline of the symptoms, and return of usual health, the 
affection was almost forgotten. In the year 1839, and about 
the same time in the year, the disease again returned, and 
has continued to do so every year since, except the last. 
She was then on a visit to Virginia ; and while there wrote 
home, that it would mar her enjoyment very much to be 
confined as usual, with this disease, and desired me to pre- 
scribe for its prevention. I did so reluctantly. Alterative 
doses of iodide of potassium were recommended to be taken 
daily, for several weeks before the expected attack. She 
complied with my instructions, and had no return of her 
annual sickness. Her general health, however, was not so 
good during the remainder of the year as it had formerly 
been. She suffered a good deal from headache, fugitive 
pains in different parts of the body, irregular appetite, and 
deficient menstruation. This summer the disease has again 
returned, and she is now convalescing from a mild attack, 
which has been mostly confined to the lower extremities. 
She looks well, and probably will be better than she has 
been for a year past. 



56 PRACTICAL VIEWS ON MEDICAL EDUCATION". 



ECLECTIC DEPARTMENT. 



PRACTICAL VIEWS OF MEDICAL EDUCATION, 

SUBMITTED TO THE MEMBERS OF THE AMERICAN MEDICAL 
ASSOCIATION, BY THE MEDICAL FACULTY OF HARVARD 
UNIVERSITY. 

The undecided state of public opinion in regard to some 
of the fundamental points in a course of medical education, 
including among other things the portion of the term of 
pupilage proper to be spent in attendance on lectures, is 
thought, by the undersigned, to justify a further consider- 
ation of the subject. In some of its relations, this subject 
has already been discussed, in the Transactions of the 
American Medical Association for 1849, in two reports, 
pages 353 and 359, to which the reader is particularly re- 
ferred. The following condensed, but more general view 
of the subject of medical education, is now respectfully 
submitted to the members of the Association. 

Boston, July 10, 1850. 

1. Medical instruction should be adapted to the power 
of students to receive and retain what is communicated to 
them, and should be confined to what is important to them 
in their subsequent life. 

2. In modern times the constituent branches of medical 
science are so expanded, that they are not acquired by any 
physician in a lifetime, and still less by a student during 
his pupilage. The same is true even of many individual 
branches. It is not, therefore, to be conceded that " a 
scheme of scientific instruction should embrace the whole 
science, and no part should be omitted;" nor that " a well- 
digested plan of lectures embraces all that is to be known 
and taught." Medical science has at this day become so 
unwieldy, and contains so much that is unnecessary, at 
least to beginners, that the attempt to explain to students 
the whole, is likely to involve the result of their learning 
but little. 



PRACTICAL VIEWS ON MEDICAL EDUCATION. 57 

3. In Chemistry, at the present time, a thorough adept 
is unknown. No man living knows all the recorded facts, 
or all that is to be known and taught, in that science. 
Organic chemistry alone fills large volumes, though yet in 
its infancy. 

4. In Materia Medica there are some thousands of sub- 
stances and their compounds, which possess what is called 
a medicinal power. Yet it is not probable that any phy- 
sician effectively reads the one-half, or remembers one- 
quarter, or employs in his yearly practice one-tenth, of the 
contents of the common dispensatories. 

5. In Pathology, so complicated and various are the 
conditions attendant on the individual forms of disease, 
and their relations with idiosyncracy, temporary condition 
and external agency, with organic lesions and functional 
disturbance, that few of the most experienced pathologists 
can be said to understand the whole science, or to be al- 
ways competent to its successful application. 

6. In Etiology, the theoretical literature of causes has 
spread itself out to an extent, which is burdensome and 
unprofitable. It is true, that " man, from his nature, is 
subject to suffering, disease and death;" — but it is not 
equally apparent, that "the causes by which these condi- 
tions are produced, are ascertainable." We know nothing 
of the vehicle of cholera or influenza, nor is it probably in 
the power of any physician, by any art, or application of 
his knowledge, to produce in a given healthy man, a case 
of common pneumonia, or of acute rheumatism — of dia- 
betes or Bright's kidney — of hypertrophy or of cancer — 
or even of a common boil, or wart. 

T. In Therapeutics, many hundred volumes exist, such 
as would not have existed, could a knowledge of the cure 
of diseases be made so easily tangible that it could be 
spread before the student in the three or five years of his 
pupilage. 

8. In Anatomy, general and special, microscopic and 
transcendental — in Physiology, with its intricate ramifica- 



58 PRACTICAL VIEWS ON MEDICAL EDUCATION. 

tions— in Surgery, of which, several subordinate special- 
ities constitute distinct living professions; it is not to be 
admitted that the means or time of any ordinary course of 
lectures can furnish full and complete instruction. Cer- 
tainly it must be difficult to arrange a course of lectures on 
any of the extensive sciences which now constitute medi- 
cine, if it be indeed true, that "the teachers are not justi- 
fiable in suppressing any portion." 

9. It is the business of lecturers in medical schools, to 
condense and abridge the sciences which they respectively 
teach, to distinguish their essential and elementary princi- 
ples, to sift carefully the useful from the superfluous, and to 
confine the scope of their teachings, as far as possible, to 
what is true, and profitable, and likely to be remembered 
and used by their hearers. It is unfortunately too true,- 
that, "in an extended system of instruction, there is much 
that the student will not master, much that will have es- 
caped his attention, much which he ought to know, that 
he has not learned." The remedy appears to be, to teach 
him well what he can and should master, and briefly to 
point out to him the sources, fortunately abundant, from 
which he may obtain the rest. 

10. Much injury is done to the cause of true learning by 
medical assumption, amplification and exaggeration, by 
premature adoption of novelties, and by tenacity of theories, 
personal or espoused. Students, in all former years, have 
expended much time in learning what it afterwards cost 
them both time and trouble to unlearn ; — in acquiring not 
merely the truths of science, but the crude announcements 
and plausible doctrines of sanguine or ingenious men. How 
much time has been wasted in some of our distinguished 
seminaries, in acquiring the visionary, and now neglected, 
theories of Rush and Broussais ! 

11. The most commonly exaggerated branch of medical 
science is therapeutics. Enlightened physicians well know 
that many diseases are incurable, and that others are sub- 
ject to laws of duration, which cannot be interrupted by 



PRACTICAL VIEWS ON MEDICAL EDUCATION". 59 

art. Yet students sometimes return from medical schools 
persuaded that their instructors know how to cure a large 
part of these diseases, and that if others are less fortunate, 
it is attributable to their own fault. 

12. Medical teachers should keep pace with the progress 
of their respective sciences. Yet, in their haste for the pro- 
mulgation of novelties, they should not omit to give the 
proper consideration to the older and more settled principles 
of science. Medical men are liable to commit the error of 
adopting premature opinions, unsound practice, and incon- 
venient changes of language and nomenclature, sometimes 
from a love of display, and sometimes from a want of self- 
reliance, and a fear of being thought behind the literature 
of their time. 

13. The length of a course of lectures is not the measure 
of its value to the student. A course of lectures should not 
outlast the curiosity of its hearers, nor their average pecu- 
niary ability to attend. Custom in this country has gene- 
rally fixed the limits of these things at about four months. 
A comprehensive and judicious course, confined to the 
enforcing of necessary points, is far more profitable than 
a more discursive course to a wearied and diminishing au- 
dience. 

14. Lectures are chiefly wanted to impress by demonstra- 
tion the practical branches of science, and they are most 
effective in places where the facilities for such demonstra- 
tions can be commanded. Anatomy requires extensive 
exhibitions by the teacher, and personal dissections by the 
student. Chemistry and Materia Medica require illustra- 
tions by specimens and experiments. Pathology needs the 
aid of autopsies, museums, and the clinical demonstrations 
of large hospitals. A knowledge of Obstetrics is not per- 
fected without apparatus and practice. Surgery is acquired 
by witnessing numerous operations, surgical diseases, illus- 
trated explanations, and by personal practice on the dead 
body. Physical exploration is wholly demonstrative. A 
knowledge of auscultation can no more be acquired from 



60 PRACTICAL VIEWS ON MEDICAL EDUCATION. 

books, or abstract lectures, than a knowledge of music, or 
of individual physiognomy. 

15. The intermediate period between lectures should be 
spent by students in active and original study, approved 
and confirmed by regular recitations, and by such oppor- 
tunities as can be commanded, for practical, personal expe- 
rience. Private schools for small classes, and the private 
teachings of individuals, who are suitably qualified and 
situated, are more advantageous for two-thirds of the year, 
than either the fatiguing jostle of overcrowded rooms, or the 
listless routine kept up by the survivors of a passive class. 

16. The usefulness of a medical school depends not so 
much on the length of its session, as upon the amount of 
education, preliminary and ultimate, which it requires, the 
fidelity with which it exacts its own professed requisitions, 
and the train of healthy exertion, active inquiry, and rigid, 
methodical, self-regulating study, to which it introduces its 
pupils. The longest lectures are of little use to students 
who want a common education, and whose medical educa- 
tion does not qualify them afterwards to observe, to inquire, 
and to discriminate. The exacted evidence of three years 
of well-conducted study, is better than the exhibited ticket 
of a six months' course. 

17. The subjects most important to be well taught in 
medical schools, are the elementary principles which con- 
stitute the framework of medical sciences, and the mode 
of thought and inquiry which leads to just reasoning upon 
them. After these, most attention should be given to se- 
lecting and enforcing such practical truths, as will most 
certainly be wanted by the young practitioner in his future 
career of responsibility. 

18. The things to be avoided by medical teachers, are 
technicalities which are unintelligible to beginners — gra- 
tuitous assumptions and citations of doubtful authorities — 
prolix dissertations on speculative topics — excessive mi- 
nuteness in regard to subjects which are intricate and but 
little used, and therefore destined to be speedily forgotten. 



HOMOEOPATHY IN GREAT BRITAIN. 61 

To these may be added controversies, superfluous, personal 
eulogiums and criminations, and all self-exaggeration, per- 
sonal or local. 

JACOB BIGELOW, Prof, of Materia Medica and Clinical Medicine. 
WALTER CHANNING, Prof, of Midwifery and Med. Jurisprudence. 
JOHN WARE, Prof, of Theory and Practice of Medicine. 
JOHN B. S JACKSON, Prof, of Pathological Anatomy. 
OLIVER W. HOLMES, Prof, of Anatomy and Physiology. 
HENRY J. BIGELOW, Prof, of Surgery. 
E. N. HORSFORD, Prof, of Chemistry. 



HOMCEOPATHY IN GREAT BRITAIN. 

We are told by the advocates of homoeopathy, that as a 
system of practice it is fast gaining popularity, and must 
ere long become universal. This is what is asserted ; now 
let us see what is the fact. 

To give our readers an idea of what homoeopathy is in 
Great Britain, we condense the following from an article 
by James Inglis, M. D., of Halifax, England ; copied 
into the Western Lancet from the London Medical Times. 

The statistics of homoeopathic practitioners are taken 
from the British Journal of Homoeopathy, and cannot 
therefore be questioned by the advocates of the system. 

1. Of London. 

The population of London amounts to about 2,200,000. 
The number of medical practitioners practicing in London, 
whose names appear in the London Medical Directory, is 
2,571. 

The number of homoeopathic practitioners practicing in 
London, according to the accredited "list" of the British 
Journal of Homoeopathy for Jan. 1850, is 48. 

Of these forty-eight homoeopathic practitioners twenty- 
two are not in the London Medical Directory at all ; and of 
the twenty-six which remain, ten are graduates in medi- 
cine, and sixteen are surgeons or surgeon-apothecaries. 



62 homoeopathy in great britain. 

2. Of the provinces. 

According to the Provincial Medical Directory, there are 
of medical practitioners practicing in the provinces, 8,327. 

According to the "homoeopathic list," already referred 
to, there are, of homoeopathic practitioners practicing in 
the provinces, 52. 

Of these fifty-two homoeopathic practitioners, sixteen 
are not in the Provincial Medical Directory at all; four are 
in it, whose qualifications are not vouched for by the editor 
of the Directory : and of the remaining thirty-two whose 
names appear in the Directory, eighteen are graduates in 
medicine, and fourteen are surgeons or surgeon-apothe- 
caries. 

The number of homoeopathic practitioners in Scotland 
appears from their " list" to be ten ; in Ireland, six ; and in 
the Channel Islands, one; making a total of 117 homoeo- 
paths to about 15,000 regular practitioners in Great Britain 
and Ireland. 

If the numbers given above be incorrect, or understated, 
the error exists in the homoeopaths' own list, which may 
be seen in the supplement to the u British Journal of 
Homoeopathy for January of the present year, from which 
alone I have taken my information. But since that list 
enumerates twenty-three M. D.'s and fifteen surgeon- 
apothecaries, whose names do not appear at all in either 
the "London" or in the " Provincial Medical Directory;" 
moreover, when we find included, in that list the one 
homoeopathic practitioner in the Channel Islands, I think 
we may infer that that list contains as many homoeopaths 
as the homoeopaths could find. 

But it may be said that we ourselves, by noticing any- 
thing so intrinsically insignificant, are elevating homoeo- 
pathy to an importance which by no means belongs to it. 
I differ, however, from this opinion ; and I consider that the 
journalist is the legitimate cotemporary historiographer of 
popular delusions ; and that through the recognized journals 



EDITORIAL. 63 



it is profitable to society to expose the errors of the day, and 
especially so in this instance, lest it should at any time be 
said that the medical press of England tacitly approved of 
anything so demonstrably absurd as homoeopathy. 



EDITORIAL. 

OUR FOURTH VOLUME. 

With the present number commences the fourth volume 
of the New Jersey Medical Reporter ; and we flatter our- 
selves with the hope that it may prove to be still more va- . 
luable to the profession than it has hitherto been. As will 
be seen on the cover, the work has gone into the hands of 
a new publisher, who, from the very fact of his being a 
medical man, will throw into it a degree of interest, which 
could not be expected of one not connected with the pro- 
fession. The mechanical execution of the present number 
will, we think, compare favorably with the best medical 
periodicals in our country, and we intend it as a fair sample 
of what shall follow. The broad seal of the New Jersey 
Medical Society, which embellishes the title-page, will be 
welcomed as a familiar friend by most of our readers, and 
under its sanction we hope to lay before them an amount 
of medical information, which may always prove to be worth 
at least the subscription price of our journal. We take this 
opportunity to urge our professional friends to send us ori- 
ginal communications, as the value of a medical periodical 
depends very much upon the amount, and character, of the 
original matter it may contain. The profession of this State 
is fully able to sustain the work. If all the members of our 
District Societies would become paying subscribers, there 
could be no embarrassment in the financial department. If 
twenty of them would consider themselves bound, each one 
to contribute an essay once a-year, we would have for each 
number of the Reporter five original articles. These, in 



64 EDITORIAL. 

addition to the transactions of the State and District So- 
cieties, bibliographical notices, and selections from other 
journals, would give an amount of valuable information 
which could not fail to be alike creditable to the profession 
of the State and the organ of the State Society. We there- 
fore invite the co-operation of the friends of medical science 
in support of this measure, and ask for volunteers to com- 
plete a list of Collaborators ; and though we hope for 
many from the ranks of the profession in New Jersey, we 
shall be glad to give room to all judicious articles from any 
quarter. We are well aware that some of our subscribers 
have had cause to complain hitherto, in consequence of a 
want of punctuality in the distribution of the work, and 
perhaps from other causes ; but we confidently believe that 
the present issue is made under more favorable prospects 
of success, and with a better hope of being well and 
promptly executed, than has existed at any period of its 
former history. With this belief, and with the assurance 
of our intention to spare no exertion to make it acceptable 
to those who may favor it with their patronage, we commit 
it to their hands. 

BIBLIOGRAPHICAL NOTICES. 

As it has been our custom to allow a full share of 
space for bibliographical notices, in former numbers of the 
Reporter, we intend to devote as much room to this de- 
partment, in future, as the size of the journal will admit. 
Sometimes we have on hand more than a supply of 
original communications, and knowing that our correspond- 
ents are always desirous of being promptly attended to, 
we exclude observations of our own, upon new publications, 
to give them a hearing ; but we anticipate an enlarge- 
ment of the journal, perhaps before the completion of the 
present volume, if this number should prove so far accept- 
able to many who may receive it, who are not already on 
our subscription list, as to induce them to become subscrib- 
ers ; want of room is our only reason for omitting the 



EDITORIAL. 65 

notice of several works, in the present instance. We hope 
that our old friends, who are not a few, will aid us in efforts 
to enlarge the subscription list, that we may increase the 
size and usefulness of the first and only organ of the New 
Jersey Medical Society. 

METEOROLOGICAL RECORD. 

In addition to other improvements, appended to the Re- 
porter will be found a monthly record of the weather, 
kept by our friend, Adolph Frost, A. M., Librarian of 
Burlington College, whose indefatigable exertions in this 
department of science have earned for him a reputation 
which entitles his reports to the highest credit for accuracy. 
The importance of meteorological observations as a means of 
ascertaining the influence of the weather upon epidemics, 
and 'disease generally, is our reason for devoting the little 
space which they occupy, to a subject which ought to inte- 
rest the profession more than it has hitherto done. We 
shall no doubt be able to furnish regular reports of the same 
kind, from the same source, with each ensuing number. 

DISTRICT MEDICAL SOCIETIES. 

We would respectfully suggest to our friends in the dif- 
ferent counties, that the meetings of the District Societies 
offer a suitable opportunity for increasing the subscription 
list of the Reporter. If those who are already patrons of 
the work, would use their efforts to enlarge its circulation 
on these and other occasions, we would soon be able to 
increase its size, and give, for the same amount of money, 
a great deal more reading matter. 

TO CORRESPONDENTS. 

Each subscriber who may contribute to the pages of the 
Reporter, shall be entitled to two additional copies of the 
number, or numbers, in which his article may be inserted; 
which the publisher will forward according to order. 
VOL. iv. — 5 



66 ECLECTIC DEPARTMENT. 

ECLECTIC DEPARTMENT. 

Dengue — Sun Fever — Break-hone Fever. — A disease 
known by these several appellations has been prevalent for 
some weeks in many of the cities on the seaboard, and to a 
limited extent in some parts of the interior. It bears a very 
strong resemblance to the Dengue which prevailed along 
the coast some twenty years since. In Charleston, where 
it is known as the Break-bone fever, it began in the latter 
part of July, and in its march visited almost the entire popu- 
lation. The editor of the Charleston Medical Journal esti- 
mates the number of cases existing at one time (22d August) 
at from ten to twelve thousand. In New Orleans, where 
it is called " Sun Fever," the cases are also quite numerous. 
We learn that it prevails in Savannah also, to a considerable 
extent. Our own city has not entirely escaped, though the 
cases are not very numerous, or severe. We have heard 
of several cases occurring in the country. 

This fever is of short duration, and rarely, if ever, proves 
fatal. The Journal already referred to, states that, after 
the most minute inquiries, in no single instance could death 
be referred to the disease per se. The fever, in some cases, 
is ushered in suddenly with chills, or violent, pains in the 
head, loins, and limbs; in others, it is preceded by slight 
headache, soreness of the flesh, &c. The pain in the head 
is generally supra-orbital, extending from one temple to the 
other; the eyes are injected and watery, with intolerance 
of light. The pains in the various parts of the body and 
limbs are often very severe, but there are cases in which 
there is little pain except in the head. The appetite is de- 
stroyed, but generally the stomach in other respects seems 
but little affected. Sometimes there is vomiting, and diar- 
rhoea, though most commonly the bowels are constipated. 
The pulse is frequent, in some cases full and hard, in others 
soft and compressible ; the skin is hot and dry, though in a 
few cases perspiration continues throughout the fever. In 
a vast majority of cases the fever is continued, and consists 



ECLECTIC DEPARTMENT. 67 

of but a single paroxysm, lasting from twenty-four to forty- 
eight hours; in a few instances it is remittent. Although 
of such short duration, the muscular prostration which ac- 
companies the disease is very great, and the convalescence 
is very slow. In a large proportion of the cases, after the 
subsidence of the febrile symptoms, a rash very similar to 
that of scarlatina makes its appearance. Occasionally the 
eruption assumes a purpuric character. 

The symptoms of the disease, as it exhibits itself in New 
Orleans, are similar to those which it presents in other lo- 
calities. It is said, however, to have proved fatal in a few 
instances. Dr. Fenner states, that in New Orleans the 
convalescence is usually "easy and rapid." 

We are unable to state what is the treatment in Charles- 
ton. In New Orleans, in young and plethoric subjects, a 
few ounces of blood are taken from the arm, followed by 
local depletion from the loins and nucha. Mild purgatives 
are employed in some cases, and full doses of quinine are 
administered as soon as the vascular excitement subsides, 
and the pain in the head and limbs is somewhat relieved. In 
our own city, we believe most cases are treated with gentle 
aperients, and stimulating sudorifics. Opiates, especially 
in the form of Dover's powder, are generally given, and 
their effects are highly satisfactory. Some physicians ad- 
minister quinine freely during the convalescence. 

A full account of the disease, we presume, will hereafter 
be furnished by some of the medical gentlemen in whose 
vicinity it has prevailed.— Southern Medical and Surgical 
Journal. 

On the Influence of Iodine on the Development of the Infant. 
By M. Delfrasse. — In a memoir recently presented to the 
Academie des Sciences, the author proposes, in place of 
diminishing the size of the child by subjecting the mother 
to a starving regimen, as recommended by Depaul, to ac- 
complish this end by administering iodine in the latter 
months of pregnancy in minute doses. He orders 1 part of 



68 ECLECTIC DEPARTMENT. 

Iodine and 2 of Iod. Pot. to 30 of water, and gives from 6 to 
8 drops of the mixture daily some time before a meal. 
After testing its efficacy upon some female animals, he em- 
ployed this substance in two appropriate cases in his practice. 
In the first patient, there was great contraction of the pelvis, 
necessitating premature delivery on former occasions. In 
two successive pregnancies, she took, during the last two 
months, first 6, and then 8 drops of solution, every morning. 
Both children were born alive and did well, having all the 
appearance of seven-months' infants, one of them weighing 
728, and the other 734 grammes less than former children 
had done. The only inconvenience was some diminution 
of development of the mother's breasts. In the second case, 
the patient had had five very difficult labors, none of the 
children living. The author ascertained that this arose 
from the narrowness of the pelvis, and upon the occasion 
of the next pregnancy, he administered the iodine. A living 
child was born, weighing 1250 grammes less than its pre- 
decessor. — Bull de Therap., vol. xxxviii, p. 474. 

On Kermes Mineral as an Antidote to Strychnia. By M. 
Thorel. — M. Thorel, taking advantage of the practice of 
the municipal authorities in destroying stray dogs periodi- 
cally by means of strychnia and nux vomica, instituted some 
experiments upon the antidotal power of kermes, having 
already observed the reactions which ensue on bringing a 
sulphuret in contact with strychnia. Although dogs com- 
mencing to exhibit the symptoms of strychnia-poisoning, 
cannot, if they have been fasting, be made to vomit even by 
large doses of tartar emetic ; yet by combining with it some 
kermes, free purging and vomiting are produced, and if the 
space of time has not been too prolonged, the animal re- 
covers. He believes that the instances in which he tried 
it justify him in recommending, that in case of poisoning by 
strychnia in the human subject, the following dose should 
be given: — Kermes 15 grains, Tart. Eniet. gr. 1J, water and 
syrup of buckthorn, 2 oz. A second or even a third dose 
may be given. 



ECLECTIC DEPARTMENT. 69 

A series of chemical experiments led him to the conclu- 
sion that the action of the substance is twofold. A portion 
is decomposed, and forms, with the strychnia existing in the 
stomach as a lactate of strychnia, an insoluble sulphuret, 
while the undecomposed portion aids the tartar emetic in 
inducing expulsive action. 

MM. Bouchardat and Gobley, reporting on this paper, 
regard it as of some importance. They observe, however, 
that experiments out of the body show that the iodated iodide 
of potassium (iodure de potassium ioduree) exerts a far more 
powerful effect in precipitating an absolutely insoluble com- 
pound with strychnia, than kermes does. The relative effi- 
cacy of the two substances can only be tested by experience ; 
and experiments on animals require to be extensively re- 
peated, lest we may be deceived by exceptional circum- 
stances. It is possible that all the advantages in M. 
Thorel's arose from the evacuations which were induced 
by the antimony and buckthorn. — Journal de Pliarmacie et 
de Ohimie, 3 Ser., xvii., pp. 185-91. 

On Precocious Menstruation. By M. Paul Dubois. — ■ 
While drawing attention to a woman who had commenced 
menstruating at 9J, M. Dubois observed that warmth of 
climate is not the only circumstance influencing menstrual 
precocity. One of the most influential circumstances is 
the condition of the uterus itself, and this is especially seen 
from the fact, that both precocity and tardiness of men- 
struation are frequently hereditary, the influence of heredi- 
tariness upon the intimate structure, and even the outward 
conformation of the organs, being well known. On several 
occasions he has found the menses become established very 
early or late, at much the same epoch in different members 
of the same family. Another influencing circumstance is 
the moral condition in which girls live. In towns and 
workshops, where young girls are constantly brought into 
company with individuals of the opposite sex, the menses 
appear much earlier than they do in girls who lead such 

5* 



70 ECLECTIC DEPARTMENT. 

different lives in this respect in the country. — Q-az. des 
Hopitaux, No. 45. 

The Kite-tail Plug. — This, which has long been em- 
ployed by M. Bretonneau of Tours, M. Trousseau regards 
as excellent in uterine hemorrhages, being both easy of 
application and withdrawal. It is formed of a thread 
about forty feet long, to which, at intervals of about six or 
seven inches, pieces of carded cotton (to be oiled before 
using the plug) are attached. M. Bretonneau prefers it to 
all other means of plugging in epistaxis. — & Union Medicale, 
No. 25. 

On the Destruction of the Odor of Mush hy Camphor. — 
The fact of musk, when mixed with some other substances 
(as sulph., antim., aurat., syrup of almonds, wax, &c), 
almost entirely losing its odor, has often been observed ; 
but the attention of M. Fleischmann has been recently 
more particularly drawn to the subject, by his finding that 
a powder, composed of musk, camphor, and sugar, lost its 
odor after mixing. Repeating the experiment, he found 
that, as often as camphor was commingled with musk, it 
exerted this effect upon it ; so, too, when musk was given 
with an oleo-saccharum, as cinnamon, &c, its odor be- 
came lost. — Buchners Bepert., Band iv. p. 262. 

Prolonged Tepid Baths as Sedatives. — M. Rostan, while 
ordering a tepid bath for two hours, to allay palpitation in 
a case of organically diseased heart, for which purpose 
digitalis had been of no avail, observed that he usually de- 
rives far more advantage from the employment of prolonged 
tepid baths as sedatives, than from the use of any internal 
medicines whatever. — Grazette des Hojntaux, No. 43. 

Removal of the Bitter Taste of Quinine. — Dr. Thomas states 
that accident led him to the discovery that the bitter of 
quinine may be effectually concealed, while the efficacy of 



ECLECTIC DEPAKTMENT. 71 

the drug is retained, by combining it with tannic acid ; ten 
grains may thus be deprived of its taste by 1 J grs. of the 
acid. — Amer. Jour. Med. Sc. N. S., No. 38, p. 541. 

On Subcutaneous Punctures in Articular Rheumatism. By 
M. Guebin. — Frequently joints which have become invaded 
by an attack of rheumatism long remain the seat of most 
obstinate pain. On a close examination, we may assure 
ourselves that this pain is neither uniform nor general, but 
partial and localized at certain points. On handling, the 
part, we can feel opposite the immediate seat of pain, little 
knotty points which are exquisitely sensible to the touch. 
Such points exist even during the acute stage of rheuma- 
tism, but are much more easily recognized and isolated in 
the subacute stage. It is towards these points that the 
subcutaneous punctures should be directed, taking care, as 
in the ordinary application of the method, to raise a fold of 
the skin. The point of the instrument divides and liberates 
this tumefied and, so to say, indurated part ; and the instant 
this is effected the pain ceases, and pressure can detect no 
trace of the nodosity thus destroyed. Whether a few drops 
of blood flow or not, the same result follows, so that the 
practice does not operate as an antiphlogistic. It is in fact 
only a debridement. — Giaz. Med., 1850, No. 22, 

On very minute Doses of Tartar-Emetic, in Phthisis and 
Asthma. By M. Beknakdeau. — In vol. xxxi. of the Bull. 
de Therap., M. Bernardeau gave an account of the great 
benefit he has seen derived from the administration of 
minute doses of tartar-emetic in the hectic of phthisis. 
Since that period he has used it in other stages of tubercu- 
lization, and in several cases of asthma, with excellent ef- 
fects. He gives from three to six pills in the twenty-four 
hours, each containing l-25th of a grain. By their use, 
the cough, dyspnoea, and inordinate action of the heart 
becomes calmed, and in fact all the good effects of morphia, 
without its inconveniences, seem to be produced. — Bull, de 
Therap., vol. xxxvii., p. 311. 











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THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. IV. FIRST MONTH (JANUARY), 1851. No. 2. 

TRANSACTIONS OF THE NEW JERSEY MEDICAL SOCIETY-. 



OLD AGE. 

An Address, read before the New Jersey Medical Society, at 
a semi-annual meeting, held at Ullizabethtown, Nov. 12, 
1850. By W. Nichols, M. D., Second Vice-President. 

Gentlemen of the Society :— 

The topic selected for my remarks on the present occa- 
sion is Old Age ; and it is hoped that the suggestions pre- 
sented, although without strict regard to method, may not be 
without interest and practical value to at least such of the 
younger members of our society as may be present. I have 
chosen it, because its pathological and therapeutical relations 
seem to me to deserve more examination than is usually be- 
stowed upon them by the medical student, or indeed by the 
profession generally. Is it not true that, in our professional 
studies, we are apt to give an undue proportion of our time 
and attention to the early and middle periods of life, to the 
neglect of advanced age ? — as if this last stage of existence, 
instead of demanding the interference of art, should be left 
alone to obey the force of those natural laws which govern 
life. We have abundant treatises on infantile therapeutics, 
and the diseases of childhood are made subjects of special 
study and research, and it is freely admitted that they receive 
no more attention than their importance and peculiar cha- 
racter deserve. But old age also has some marked patho- 
logical features ; and certain diseases, both of structure and 
function, are found in this period of life, which are properly 
vol, iv, — 10 



76 DR. NICHOLS S ADDRESS. 

peculiar to it. May we not be chargeable with neglect m 
respect to our attention given to the diseases of this class, 
either from the conviction that they are less susceptible of 
relief from art, or from a culpable indifference to the wants 
and claims of the aged ? It is to be feared that a principle, 
kindred to this last, to wit : a disposition to bestow all care 
upon the wants and conditions of other classes, to the neglect 
of this last period of life, may be observed in all the depart- 
ments of society. While we have our numerous charities for 
the care and comfort of the young ; our asylums for orphans, 
foundlings and destitute children ; all commendable and 
praiseworthy, as must be admitted — are they not the promi- 
nent objects, which appear in a clear light in the circle of our 
benevolence, while corresponding institutions for the aged 
are few and scattered, as if holding the place of a doubtful 
philanthropy ? Too often the alms-house is the only asylum 
for a class of persons, who, however virtuous and worthy in 
all previous life, have arrived at a period when to them age 
has become a misfortune, receiving little less pity or regard 
than if it were a crime. The subject is commended to the 
consideration of those philanthropic reformers, who would fain 
lavish their sympathies upon evils at a distance, and which, 
at present, admit of no relief ; while the wants and claims of 
the aged are in full view and at their very door. 

Old age and advanced age are terms which we shall use to 
denote the last period of human life, without attempting to 
define its limits, which must vary in different individuals, from 
different constitutional causes, temperaments, employments, 
and previous diseases. With some it may be said to com- 
mence as early as the fiftieth year of life ; in females earlier 
than in males ; while in others it seems postponed to a much 
later period — but in all, it is that stage of human existence 
in which the vital forces show unequivocal marks of languish- 
ment and decline ; when the elasticity of youth and the vigor 
of manhood are followed by a condition, in which are mani- 
fested symptoms of decay in all the powers both of body and 
mind. This epoch is marked, first, by certain physical 



DR. NICHOLS'S ADDRESS. 77 

changes, both organic and functional, most of which are so 
familiar as need barely be adverted to. The gray hair, the 
wrinkled skin, the tremulous voice, the uncertain step, and 
the impaired senses, particularly of sight and hearing, all 
indicate some change in the physical structure of the parts to 
which they stand related. This change pervades the whole 
ganglionic and cerebro-spinal systems, and affects all the nerves 
which influence animal or organic life, impairing their sensi- 
bility, and rendering them less obedient vehicles of volition. 

Thus, the impressions made on the organs of sense become 
dim and imperfect, and the muscles of voluntary motion obey 
with slowness and uncertainty the mandates of the will. In 
the circulatory system, similar changes of function are observ- 
able ; the heart's action becomes slower, and unless affected 
by organic lesion, more feeble — the calibre of the arteries is 
diminished, while the veins become more dilatable, and un- 
dergo an increase of size. The secretions and excretions are 
diminished in quantity, and exhibit constituent changes ; and 
all the functions influenced by the ganglionic system and the 
organs of circulation, as digestion, assimilation and absorp- 
tion, evince an impaired action. Certain alterations of struc- 
ture also are observable in various organs and tissues — greater 
density in the bones, the brain, the heart and arterial coats, 
the fibrous and serous membranes. These examples may suf- 
fice to illustrate the changes which are exhibited in the phy- 
sical powers in the last period of life. 

Secondly. Old age is marked by obvious changes in the 
condition of the mental powers. As in the body, so in the 
mind, it is a period of decline ; appearing sooner or later, and 
influenced in the mode and period of its approach by many 
external causes. Present or previous bodily infirmities, cer- 
tain diseases involving the cerebral organs, certain constitu- 
tional temperaments, mental culture, the influence of the 
moral sentiments • and all those circumstances which affect 
the social condition of life, have a decided agency either in 
hastening or retarding the course of decay in the mental 
powers. I think it is also observable that the advent of this 



78 dr. Nichols's address. 

period seems sometimes to be influenced by hereditary tenden- 
cies — as might be supposed that similarity in the bodily 
organization is accompanied by obvious psychological resem- 
blances. Certain it is that, in some families, the impaired 
condition of the intellect which is proper to advanced age 
appears at a much earlier period ; and symptoms of mental 
decline are exhibited in a stage of life when the mass of man- 
kind are in the maturity of their power. 

Closely connected with this subject is the efficiency of cer- 
tain causes which are related to man's moral and social nature, 
and which promote the exercise of cheerful and pleasurable 
emotions ; such as suitable amusements, recreations, innocent 
mirth and hilarity, which are observed to exert a favorable 
influence in prolonging a healthy condition both of body and 
mind. The examination of the whole subject of mental 
hygiene is well worthy the attention of the medical student. 
The influence of certain pursuits, requiring mental application 
in a certain fixed and steady direction; certain professions 
employing the faculties in due proportion and harmony ; the 
exercise of the moral and religious sentiments ; together with 
innocent indulgence of the pleasurable emotions, would be sub- 
jects of interesting inquiry. Again, in what manner, and 
with what force the principle of habit alone may act in pre- 
serving vigor and soundness of mind, even when the restric- 
tions which its very condition imposes, would seem unfavor- 
able to this end. It is certain that, upon this principle alone, 
however we may explain it, must we account for certain facts, 
which contradict our philosophical inductions, and are in 
seeming violation of all the fixed rules of our physical and 
mental being. Abundant cases might be cited of apparent 
mental vigor in extreme age, among certain classes of men 
whose habits of life would seem to be strangely adverse to 
the healthful exercise of the mental powers ; stern ascetics, 
misers, religious recluses, men of single ideas and pursuits, 
over whose path in life scarce a ray of kindly joy has ever 
beamed. The undeviating pursuit of a single object, attended 
with no emotion of pleasure except what may spring from 



dr. Nichols's address. 79 

hope or anticipated success, has changed the man literally 
into a creature of habit, and degraded his mental powers from 
their original endowment to a mere mechanism ; whose whole 
merit consists in the regularity and precision of its movements. 
Strange that such violations of the laws of our mental consti- 
tution should, in so many instances, be rewarded with a suc- 
cess denied to the more rigid observance of the precepts of 
philosophy and sound reason. 

Usually, the faculty of mind which first exhibits the marks of 
decay is memory. This manifests itself at first in an imper- 
fect recollection of the names of persons and things ; next of 
recent occurrences, while facts and events which have made a 
strong impression on the mind in early life are retained in 
clear remembrance. This faculty of recalling mental impres- 
sions, as might be expected, yields less readily in those in 
whom it has been improved and strengthened by previous 
habits of methodical discipline and intellectual culture. Next 
in order to exhibit symptoms of decline is the power of atten- 
tion, or that faculty by which the mind is enabled to apply 
itself fixedly to the facts presented to its notice. It has a 
close connection with the one just mentioned, and is capable 
of vigorous action only when the other is unimpaired. De- 
pendent on both of these, and usually last to desert its seat, 
is judgment or the reasoning faculty ; the power of comparing 
facts, and mental impressions with external objects, retaining 
more or less activity to a longer period than either of the other 
powers of the mind. It is not an uncommon occurrence to 
find aged persons arriving with promptness and ease to 
an accurate judgment, although the other faculties concerned 
in the apprehension of the facts were slow and dull in the 
performance of their office. Here, again, we may observe the 
force of a principle before adverted to, viz : habit in controlling 
the operation of the reasoning powers. By a long-continued 
exercise, and a steady train of ideas, the mental process be- 
comes uniform in its acts, and the conclusions of the judg- 
ment clear and correct, so that in subjects long familiar, old 
age may retain the discrimination of manhood. The farmer 



80 DR. NICHOLS'S ADDRESS. 

may exhibit a sound judgment in all that respects the proper 
management of his farm, while the simplest subjects relating 
to trade or commerce may elude his apprehension — the coun- 
sellor or judge may form an accurate opinion upon questions 
which are similar, or closely analogous to those with which he 
had long been familiar ; while upon other more complex pro- 
positions, involving new principles and different modes of rea- 
soning, he may exhibit to others, and even to himself, the 
marks of utter incompetency. The same principle is ascribed 
to our profession ; but here this difference is observable, that 
the cases submitted to the examination of the physician so 
vary in their character, are often so complex, and so much 
modified by external causes, that less room is furnished for 
the application of fixed and undeviating rules, unless with 
those who prefer the easy habit of a routine practice to that 
of patient discrimination. 

This decline in the mental powers of the aged is accom- 
panied with corresponding debility of the moral faculties. 
The sensibility becomes dull and blunted ; and except in some 
cases, and in reference to objects connected to them by the ties 
of early association, in which they may manifest strong and 
affecting interest — impressions are more slowly made, and 
more easily effaced. The moral emotions become more feeble 
and uncertain in action, as the intellectual faculties fail to 
grasp the objects appropriate to their exercise. Thus, the 
last epoch of existence is marked by languishment and decay 
in all the higher faculties of our nature ; the process of de- 
cline commencing sooner or later, but sure to come to all if 
life be protracted, and to go on with regular steps, until it 
ends in complete imbecility, and man becomes but the mere 
wreck of his former being; as at the dawn of his existence, so 
now at its close, an object appealing to our care and sympathy. 
I would here remark that this enfeebled condition of the 
mental powers, when it reaches a certain stage, is ranked 
under the general term unsoundness of mind, although it dif- 
fers from insanity. 

True, aged persons may become insane ; and in some rare 



DR. NICHOLS'S ADDRESS. 81 

cases the moral powers may become so enfeebled, and the* 
distinctions between right and wrong so dimly perceived, that 
in the eye of the law and reason, crime in such is stripped of 
its culpability — yet the distinction between the two is obvious. 
The principle of insanity consists in delusion, or a false im- 
pression of the mind, which cannot be corrected by external 
objects, or by the mental process — the essence of unsound- 
ness of mind in this class lies in mere debility of the mental 
powers ; the apprehensions of the intellect not being false, 
but so feeble as to forbid its healthy exercise. I may here 
remark, in connection with this topic, that as it stands in rela- 
tion to forensic medicine, it is worthy the attention of our 
profession. The existence and degree of unsoundness of 
mind in the aged, how far it may invalidate contracts, busi- 
ness transactions, and the testamentary disposal of property, 
are questions which frequently become subjects for judicial 
investigation. Medical men are summoned as expert wit- 
nesses, and much weight is properly given to their testimony. 
Need I say, in forming our conclusions, we should use the 
precaution of examining the history of each case, in all its 
past, as well as present aspects — lest on the one hand we fall 
into the error of mistaking eccentricity of character natural 
to the individual, although, perhaps, become more prominent, 
for aberration of mind — or, on the other hand, that shrewd- 
ness and clear judgment exhibited by many aged persons on 
matters so familiar to the mind as to be mere subjects of 
habit, be confounded with the marks of an unimpaired intel- 
lect, capable of employing its powers in proper harmony 
alike upon all subjects submitted to its exercise. We should 
bear in mind that, in this advanced period, though there may 
be apparent soundness in the operations of the mind, when 
their movement is only in one direction, yet the harmonious 
play of all its faculties may be greatly disturbed, or entirely 
destroyed ; that the caution of mature age may be succeeded 
hj an easy credulity ; when man may become the dupe of the 
designing and unprincipled, able only feebly to oppose to the 



82 DR. NICHOLS'S ADDRESS. 

plausibilities of fraud, such lessons of experience as may not 
have been already effaced from the memory. 

Although, in the advanced stage of mental decline, the fact 
may not be a matter of attention or concern to the subject 
himself, yet in many persons, in the earlier periods of this 
stage, the conviction of the truth is felt and acknowledged* 
In others, again, so gradual is its approach, or so repugnant 
is the fact to the suggestions of their pride, or to the success 
of their plans in life, that they resolutely refuse to admit its 
reality. For this, and other good reasons, the constitutions 
of several States have wisely limited the term of office of its 
Judiciary to a certain period of life — not that in every case 
increased age may be a source of disqualification, but thereby 
avoiding the necessity of deciding difficult questions of in- 
competency from this cause, where the truth might not be 
equally apparent to all, and least of all, to the subject him- 
self. So, on the other hand, in the disposal of property by 
will, the law has wisely determined no period in which alone 
the act is valid. Not that there is no such period, beyond 
which, in most cases, it is not safe to pass ; but because the 
nature of property is so variable in kind and value, and be- 
cause the relations between the parties concerned are so 
changeable in their condition, as to render its execution or 
alteration at a late period both just and expedient ; the law 
reserving the right, however, of deciding upon the validity of 
the act upon other grounds. 

I return from what may almost be considered a digression, 
to consider the last topic, upon which I propose to make but 
a few remarks, viz. — the therapeutical indications in the dis- 
eases of old age. It will be my purpose simply to call to 
mind some general principles which apply to the treatment of 
diseases as found in this class — without adverting to such 
diseases as are more properly peculiar to it, in which import- 
ant organs are the seats of structural lesions, each of which, 
would furnish abundant material for a separate essay. 

In the treatment of disease in the aged, we must keep in 



DR. NICHOLS'S ADDRESS, 83 

view certain principles, founded upon the pathological condi- 
tions alluded to in another part of this essay. If this period 
of life be marked by a decrease of vital energy, less resist- 
ance will be offered to the assault of disease ; inflammatory 
affections will be found to be more rapid in their course, and 
if severe in character have a fatal issue. Therefore, reme- 
dial means, to promise success, must be employed early. — 
Again, these remedial agents, if calculated to lower the 
powers of life, must be employed cautiously, lest the resist- 
ance offered by the vital forces be rendered still more feeble, 
if not entirely extinguished by means appropriate in them- 
selves, but injudiciously used. In the aged, particular regard 
must be had to peculiarities of temperament, previous habits, 
constitutional infirmities, condition in life, and the effect 
of other known causes which influence disease. But as a 
general rule, in this class of persons depletion must be cau- 
tiously employed ; and under this term I include not only 
blood-letting, but all those remedies calculated to lower the 
vital forces, whether in the nervous or circulatory systems. 
When venesection is carried to any considerable extent, its 
effect should be carefully watched, lest fatal exhaustion should 
ensue ; and if cathartics are employed, it may be proper to 
exhibit them in combination with some aromatic or stimulant, 
and closely observe their action, lest it be too energetic or too 
protracted. In the use of all such remedies, due precaution 
should be observed, lest in our endeavors to eliminate dis- 
ease we waste all the constitutional energy necessary for its 
successful resistance ! The young and inexperienced prac- 
titioner who attacks the maladies of the aged heroically 
with the indiscriminate use of the lancet, antimony and calo- 
mel, may have the misfortune of witnessing his patients arriv- 
ing at their allotted boundary, as it is called, in a much 
shorter period than if left to the care of nature and a judi- 
cious nurse. The strength of the aged patient must be sus- 
tained, in some cases, by a restorative regimen, and by 
nutritious aliment ; by a due attention to warmth, both of 
clothing and apartment ; and in convalescence, by the judi- 



84 dr. Nichols's address. 

clous use of agreeable tonics and cordials. In this stage of 
life, the depressing passions exercise a strong control over 
disease ; it becomes, therefore, our duty to guard against 
them. Youth is proverbially buoyant and full of hope : man- 
hood is too much absorbed in its pursuits and plans to yield 
its hold on life without a vigorous struggle ; but old age is 
apt to be despondent, and oppressed with the conviction that 
each assault of disease is a new summons, bidding him prepare 
to obey the inevitable law of his being. While the truth is not 
to be withheld where the issue is evident, in all doubtful cases, 
and especially where the aspect is favorable, powerful aux- 
iliaries will be found in all those encouragements and assur- 
ances, calculated not only to produce calmness and cheerful- 
ness, but also inspire hope and confidence. I need not say 
that all our professional intercourse with the aged should 
eminently be governed by the laws of human kindness ; a 
proper deference should be shown to their wishes — forbear- 
ance with their weaknesses — patience with their waywardness 
and petulance — and a cheerful attention be given to all their 
wants and complaints. The same precept which bids us "rise 
up before the hoary head," inculcates in its spirit all the 
offices of sympathy and kindness ; and I am persuaded the 
older we grow the more forcible appears the reasonableness 
of the duty enjoined. 

As in restoring health, so in preserving it in this class of 
persons, regard must be had to those causes which affect our 
mental constitution. Our therapeutics include the mind as 
well as the body : so also our prophylactic measures must 
embrace both. While we employ means designed to keep in 
healthful play the vital functions, without exhausting them, 
we must also have recourse to those means which respect 
man's higher nature, and which tend to preserve the integrity 
of his intellectual and moral powers. The means appropriate 
to preserve this soundness of condition in the mind are those 
which secure the cheerful and harmonious exercise of all its 
faculties, such as agreeable intellectual employment — variety 
in recreations and amusements — occasionally the excitement of 



MINUTES OF THE NEW JERSEY MEDICAL SOCIETY. 85 

new pursuits without suddenly abandoning those long familiar 
— social intercourse with the young, and a participation in their 
plans and innocent amusements. Lastly, to this end may be 
mentioned such an arrangement relating to business, as shall 
rid the mind of apprehension and disquietude — exemption 
from those cares and vexations which are depressing in their 
influence, and that proper cultivation of the moral and reli- 
gious affections which, in the evening of life, cheers the pre- 
sent state with contentment and peace, and throws over the 
future the radiance of hope. 



MINUTES OF THE LATE SEMI-ANNUAL MEETING OF THE 
NEW JERSEY MEDICAL SOCIETY. 

At a semi-annual meeting of the New Jersey Medical So- 
ciety, held at Elizabethtown, Nov. 12, 1850, the Counties of 
Essex, Somerset, Burlington, Camden, Salem, Mercer, Hun- 
terdon and Morris, were represented by delegates. 

The first Vice-President, Dr. J. EL Phillips, called the So- 
ciety to order. 

Fellows Peesent. — Drs. J. B. Munn, J. W. Craig, F. 
Schenck, and S. H. Pennington. 

The minutes of the last meeting were read and approved, 
when Dr. W. Nichols, third Vice-President, read an address 
on " Old Age," for which the Society granted a vote of 
thanks, and requested a copy for publication. 

The committee on Benevolent Fund, submitted a Report, 
with a Constitution, which w T as accepted, and laid upon the 
table for the present. 

The death of Dr. E. J. Marsh was announced by Dr. S. 
H. Pennington, who remarked substantially as follows : — 

We meet to day, Mr. President, under peculiar and afflict- 
ing circumstances. The place you so worthily occupy, we 
hoped to have seen filled by. another whom we all loved, but 



86 MINUTES OF THE NEW JERSEY MEDICAL SOCIETY. 

whose face, in this life, we shall not be permitted to look upon 
again. The President of this Society, Dr. Elias J. Marsh, 
has been called from his earthly labors, to receive the awards 
of a well-spent life in another state of being. An occurrence 
like this, affecting, as well because of the endearing qualities 
of the deceased as on account of the fact that it is the first 
instance, in a history of eighty-four years, in which this 
society has been called to mourn the death of its presiding 
officer during his term of office, should not be permitted to 
pass without notice, and the reflections it is fitted to inspire. 
Until I came here to-day, I had hoped that another gentle- 
man, a member of the District Society, to which Dr. M. be- 
longed, one who had been his pupil and enjoyed his confidence, 
who was in daily intercourse with him in health, and in his last 
sickness was at his bedside, and who could have furnished 
us with an interesting biography of the deceased, would have 
been here to announce in more appropriate language, though 
not with more heartfelt emotion than I can, the sad loss 
the profession and our society have in his death sustained. 
In the absence of that gentleman, the sadly grateful office 
has been devolved on me ; and I regret that, through want 
of premeditation, and knowledge of biographical incident, I 
shall be compelled to discharge the duty so imperfectly. 

The late Dr. Marsh was a native of this State, and was 
ever sensibly alive to everything that concerned her honor. 
He was born of highly respectable parentage, in the County 
of Middlesex, in the year 1803. He early evinced a fond- 
ness for intellectual pursuits ; and in conformity with the bent 
of his mind, he was placed under competent instructors in the 
classics ; and after a proper course of preparatory study, en- 
tered Columbia College, in the city of New York, where he 
obtained with great credit his academic degree. Possessed 
of an intellect of no ordinary brilliancy, which he had culti- 
vated and disciplined by patient application, he added to the 
native graces of his mind literary attainments of a high 
order ; and he was thus fitted to shine in departments of pro- 
fessional life, not more useful indeed, but affording more ample 



MINUTES OF THE NEW JERSEY MEDICAL SOCIETY. 87 

opportunity than do the humble walks of our profession, for 
the display of brilliant natural endowments and showy accom- 
plishments. After completing his academic course, Mr. M. 
was placed under the pupilage of Dr. Alexander H. Stephens, 
of New York ; and finally received his medical degree from 
the College of Physicians and Surgeons of the same city. 
It was his good fortune to enjoy the continued friendship and 
confidence of his distinguished preceptor during the whole 
period of his professional life : and it is not among the least 
alleviating circumstances connected with the afflictive event 
we deplore, that he had the benefit of that preceptor's attend- 
ance and counsel during the illness that closed his earthly 
career. On receiving his medical degree, Dr. Marsh availed 
himself of a favorable opening in the town of Paterson, occa- 
sioned by the retirement of the late Dr. Ellison ; to whose 
practice, with entire cordiality on the part of his venerable 
predecessor, he succeeded. In this field of professional labor 
he continued till his death. How successful he was in secur- 
ing the confidence and affection of those whom he profession- 
ally served, and of the community in which he resided, the 
long funeral train, composed of weeping friends and neigh- 
bors of both sexes, and of every condition in life, gave melan- 
choly testimony. How solicitous he was for the honor of the 
profession, how enthusiastic was his devotion to its advance- 
ment, I need not describe to you, who have so often witnessed 
and admired it. I am sure my brethren here will unite 
with me, when I say that I know of none within the limits of 
our organization whose scientific attainments and profes- 
sional skill have been worthy of more sincere respect ; none 
who, the opportunities for intercourse considered, has by his 
moral and social qualities secured a larger place in the heart's 
cherished affections. 

But Dr. Marsh's excellencies were not confined to the 
walks of his profession. While he kept even pace with the 
rapid advances of medical knowledge, and contributed his 
share to promote its onward progress, he was not negligent 
of the cultivation of that general scholarship which adds 



88 MINUTES OF THE NEW JERSEY MEDICAL SOCIETY. 

grace to learning, and gives completeness to the manly cha- 
racter ; and it was not the least interesting of the traits of his 
domestic life that he found one of his highest pleasures in per- 
sonally superintending the classical education of his children. 
Nor was he inattentive to the moral and mental wants of the 
community in which he lived. The church, the public school, 
the various provident and benevolent institutions for the ame- 
lioration of the condition of the industrious and the indigent, 
all found in him a friend, a helper, and a counsellor. 

There was one other relation — where the affections and vir- 
tues of our deceased friend found their fullest, their most 
beautiful development. But I may not, even on this occa- 
sion, intrude upon the sanctuary of the domestic fireside; 
and there are sorrows, as there are joys, with which a stranger 
may not intermeddle. 

Of the illness which terminated his useful life, I regret 
that I am not able to give a minute description. It com- 
menced with an attack of intermittent fever, accompanied 
with a peculiarly painful state of mental depression ; on 
account of which he was advised by medical and other friends 
to seek a change of scene by a visit to the city of New York. 
Soon after his arrival there, his disease became more serious, 
assuming the typhoid form, and becoming complicated with 
diarrhoea, rapidly prostrated him. It is a consolation to know 
that, amid a circle of medical friends in that city, embracing 
some of the most distinguished our land can boast, he received 
every attention that friendship could bestow, and all the assist- 
ance which the best professional skill could render. But all 
in vain. / 

On the 30th of October, he died, in the forty-eighth year 
of his age, having been engaged in active medical practice 
twenty-three years. The nature of his disease did not admit, 
during the latter period of his illness, of any very marked 
intellectual manifestations ; it is cheering, however, to be 
assured that enough was evinced to satisfy his sorrowing 
friends that his end was serene and peaceful ; and that, in 
the last trying moment, when earth and its vanities were 



MINUTES OF THE NEW JERSEY MEDICAL SOCIETY. 89 

fading on the physical sight, his spiritual vision was illumined 
by those bright rays of hope that have their source in an 
abiding faith in an atoning Saviour. 

I move you, Mr. President, that a committee be appointed 
to prepare suitable resolutions, expressive of our respect for 
the memory of our late President, Dr. Elias J. Marsh, and 
that the same be communicated, with our respectful sympa- 
thies, to his bereaved family. 

Whereupon, Drs. S. H. Pennington, S. Lilly, and J. B. 
Munn, were appointed, who prepared the following resolu- 
tions : — 

Resolved, That the Medical Society of New Jersey have 
heard with unfeigned sorrow of the decease of Dr. Elias J. 
Marsh, an honored member, and late President of the society. 

Resolved, That in the death of Dr. Marsh, the medical pro- 
fession in this State has cause to mourn the loss of one of its 
most distinguished ornaments ; this society, a constant friend 
and wise counsellor ; and its members personally a valued 
and cherished associate ; and that while, as becomes us, we 
reverently bow to the afflictive dispensation which has removed 
him from us in the prime of his usefulness, and at a period 
in the history of this society, when the guidance of his ma- 
tured and cultivated intellect seemed most needed to direct 
its counsels, we would gratefully record our appreciation of 
his virtues, and our desire to emulate the graces by which he 
was distinguished. 

Resolved, That the society cordially approve and sanction 
the recommendation of the officers and fellows in the vicinity 
of the late residence of the deceased, that the members of 
the society, in token of their respect for his memory, wear 
the usual badge of mourning for thirty days. 

Resolved, That the Secretary communicate a copy of these 
resolutions to the family of the deceased ; and, in the name 
of the society, tender our respectful sympathies, with the sin- 
cere prayer that He who has declared Himself to be the 
widow's God and the Father of the fatherless, may graciously 



90 MINUTES OF THE NEW JEEBEY MEDICAL SOCIETY. 

visit them with, his consolations, and grant them a happy 
issue out of all their afflictions. 

On motion, it was Resolved, That the vacancy occasioned 
by the death of Dr. Marsh, in the committee on Charter, be 
filled ; whereupon, Dr. J. B. Munn was appointed. Dr. Lilly 
was added to the committee. 

On motion, the report of the committee on Benevolent 
Fund was referred back to the committee, with instructions 
to report at the next meeting a Constitution and By-Laws, 
as separate and distinct from the By-Laws of this society as 
may be consistent with the existing supplement to the charter. 

Adjourned. 

W. PEIRSON, Bee, Sec. 



ORIGINAL COMMUNICATIONS, 



A CASE OF SCIRRHOUS DISEASE, 
BY J. LEWIS DORSET, M. D. 

I will relate some of the. particulars of a case that came 
within the sphere of my practice, in the person of an old 
lady about sixty years of age, on account of its novelty in 
this section of country, and the deep interest that was ex- 
cited in relation to it. When my attention was first called 
to her, I found her complaining of a painful tumor and burn- 
ing sensation, seemingly near the pyloric extremity of the 
stomach. There was very little constitutional disturbance, 
and I directed her to take a little anodyne and refrigerant 
medicine, with a gentle aperient ; a small portion of blue 
mass was occasionally given to remove the indications of a 
slight derangement of the hepatic and gastric functions, and 
she got apparently considerably better, but still complained 
of a lump about her stomach ; and I found upon examination, 
bj palpation, an unnatural body about the size of a hen's 
egg ; this occurred in June. 

About a month after, she grew gradually worse, and my 
visits were repeated more regularly and frequently, and 
I had an opportunity of watching the development of her 
malady, and the extension of a tumefaction of or about the 
left lobe of the liver, towards the umbilicus and epigastrium, 
distending the epigastric depression. Diagnosis was now con- 
jectural, and the treatment was accordingly merely pallia- 
tive. I now called to my aid my esteemed friend Dr. J. G. 
Skelton, a man of science and enlarged experience, but he 
seemed as much puzzled to determine the precise nature of 
the affection as I had been ; and brought with him, on his 
second visit, a medical friend of great experience ; but still 
VOL iv.— 11 



92 A CASE OF SCHIRRHOUS DISEASE. 

our combined powers as diagnosticians were baffled, for we 
could not satisfactorily construe the symptoms, nor interpret 
the language of suffering humanity — it was to us quite unin- 
telligible. The ravages of the disease began now to progress 
more rapidly ; her sufferings becoming greatly aggravated ; 
her complexion icteric ; her extremities oeclematous ; circular 
spots of a purple hue ; purpura, and an enlargement of the 
abdomen from dropsical effusions. She died in about a week 
after the supervention of these unfavorable symptoms on the 
8th of September. 

Autopsy. — The next day, aided by Drs. Skelton and Car- 
ter, I made a post-mortem examination, commencing the " sec- 
tio cadaveris, n by an incision at the scrobiculis cordis, and 
running down to the left and right hypochondriac regions, 
thus making a V-shaped incision of the abdominal integument 
and muscles, which I everted, and exposed an enormously en- 
larged liver, with a small circumscribed adhesion to the ante- 
rior parietes of the abdomen. The liver presented a nodu- 
lated surface prior to death, which had disappeared on 
dissection. We attributed the subsidence of these inequali- 
ties, detectable by the touch, to the rapid decomposition that 
took place. It was augmented to four or five times its natu- 
ral size, presenting a mass of granular degeneration, con- 
taining dark circumscribed spots, which I was inclined to 
pronounce melanosis of the liver. 

Not being satisfied that this was the only organ involved 
in the disease, I pursued my investigations further; and upon 
an examination of the pancreas, I found it converted into a 
hard tumor about the size of a turkey's egg, and cutting with 
the crispness of an Irish potato. I now felt satisfied in regard 
to my strongest conjecture, viz., that she was laboring under 
a scirrhous affection. I was induced to entertain this opinion 
from the lancinating and paroxysmal character of the pains 
that tortured her, and made her life a burden, from which 
she seemed anxious to be liberated ; but I could not before 
ascertain the extent and number of the organs involved in 
the disease. 

Alvaston, Virginia, Oct. 12, 1850. 



ENCEPHALOID DISEASE OF THE KIDNEY. 93 



CASE OF ENCEPHALOID DISEASE OF THE KIDNEY. 
BY W. NICHOLS, M. D. 

G. D., aged four and a half years, of a rather delicate 
constitution, large head, pale complexion, blue eyes, lymph- 
atic temperament ; has had no illness worthy of notice, ex- 
cepting whooping-cough, about sixteen months since. During 
the last spring, he was observed, at times, to show marks of 
slight indisposition, and to droop in spirits and activity ; from 
which, however, he would rally again — and this alternation 
of illness and apparent health continued during half the sum- 
mer ; with, however, a manifest loss of flesh and strength. 
In the latter part of July, the parents discovered a swelling 
of considerable size in the abdomen, and my attention was 
called to the case. The tumor was found to occupy a large 
space in the abdomen, extending from a point a little below 
and to the left of the epigastric region, where it was most 
prominent, to the right hypochondriac space, which it entirely 
filled ; thence descended to the right iliac region, and again 
returned to the left side of the epigastrium, with a well-de- 
fined edge, slightly concave near its upper part. Little pain 
in the tumor, even upon firm pressure — no discoloration of 
the eyes — skin pale — no oedema of the feet — digestive func- 
tions but little impaired. These symptoms hardly warranted 
us in assigning the disease to the liver, although its locality 
seemed to point to that organ. Professor Parker, of New 
York, upon examining the case, pronounced it Encephaloid 
Cancer of the Kidney, corresponding closely to two cases re- 
ported by him in the last No. of the New York Journal of 
Medicine, except that, unlike those, this case was not pre- 
ceded by any eruptive disease. The diagnosis was verified 
by a gentleman expert in microscopic examination, who dis- 
covered encephaloid matter in the urine. From this time, 
the tumor rapidly increased in size until it filled more than half 
the abdomen — emaciation became great, with less febrile excite- 



94 ENCEPHALOID DISEASE OF THE KIDNEY. 

ment, and less impaired condition of the digestive functions 
than might have been expected. Toward the last of his ill- 
ness, the urine, which had been quite natural, both in appear- 
ance and quantity, became scanty, and at times bloody and 
turbid — paroxysms of pain were felt in the right iliac region, 
extending to the groin and thigh — nausea and vomiting of 
bilious matter — great listlessness, although the mental facul- 
ties were unimpaired — and a gradual decay of vital power, 
which ended in death on September 14th. 

Autopsy. — Great emaciation of the body — the tumor was 
found to fill the greater part of the abdomen, and to be a 
cancerous affection of the right kidney, exhibiting in its struc- 
ture the marks peculiar to what is termed encephaloid dis- 
ease. It weighed four and a half pounds — was of an irregular 
oval appearance ; grayish color, except in some livid spots 
where suppuration had commenced ; was firm to the feel, 
although containing pus in some parts of its structure. It 
was firmly adherent to the peritoneum and liver, and some of 
the intestines by bands of false membrane. The caput coli 
was found in the left iliac region, and all the intestines were 
crowded near this space. The left kidney, and all the other 
abdominal organs appeared healthy, except that the liver 
was considerably shrunken in size. 

The case is interesting, inasmuch as it shows how imper- 
ceptible may be the invasion of disease in this organ ; how 
far it may progress, without affecting materially the general 
health, and how protracted may be its course. 

Newark, Nov. 22, 1850. 



REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 95 



REVIEW OF "REMARKS ON THE USE OF JARVIS'S AD- 
JUSTER IN FRACTURES OF THE OS FEMORIS; WITH 
CASES, BY JOB HAINES, M.D." 

[New Jersey Medical Reporter, Vol. III., No. 3, p. 270.] 

BY G. 0. JARVIS, M. D. 

Through the kindness of a friend, I have recently been 
furnished with a single number of your excellent Journal, 
April 15th, 1850. Although much pleased generally with 
the tone and character of the articles which are contained in 
it, still, it appears to me that one of them should receive 
some notice from under my hand. I refer to " Remarks on 
the use of Jarvis's Adjuster in Fractures of the Os Femoris, 
with cases, by Job Haines, M.D." 

Of Dr„ Haines's real case, the lad of fourteen, I have 
very little to say. The case was, doubtless, ultimately well 
treated. It also resulted well— just as many others of like 
character have done before, where the same means were used 
which he finally employed, and after others had failed, as 
they did in his case. 

The same may also be said of the failure under the primary 
treatment by Desault's splint, Scultiti's bandage, &c. That 
too resulted just as many others have done before, under that 
treatment ; to, at least, threaten the existence of a " false 
joint ;" indeed, they have not only been threatened, they have 
too often had the false joint to follow their use. 

It is to be presumed there was nothing in Dr. Haines's 
mode of using that apparatus which was peculiar, or which 
rendered his liable to those results more than others ; for 
nothing is more reasonable to my mind than that we may 
expect such disasters occasionally — indeed, frequently to fol- 
low the use of those means in fractures of the upper third of 
the femur, to say nothing of the middle and lower thirds. 
And I cannot but here congratulate Dr. Haines on being so 
fortunate as to have the necessary apparatus brought to his 
hand in time to avoid the disaster, which he had so much 



96 REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 

reason to fear would follow from his two months' delay of 
bony union. 

Until surgeons have resolved, in treating fractures of the 
femur, to adopt the practice of dividing the tendons of the 
psoas magnus and iliacus internus muscles on the one side ? 
and of separating the two heads of the gastrocnemii from the 
condyles of the femur on the other (and, perhaps, the ten- 
dons of some few other muscles), to accommodate the use of 
the straight splint of Desault, they must not be surprised if, 
under its use, they occasionally, ay, frequently find a dispo- 
sition in the fracture to assume the character of "a false 
joint." 

Under the use of the straight splint, it may safely be laid 
down as a rule, that of all the causes of displacement of the 
ends of the fractured bone, there are none to compare with 
the action of the above-named muscles in producing such 
derangement, especially the two first, and no- other cause has 
the surgeon so much reason to dread. 

Maclise says, and very truly, " when the femur is frac- 
tured immediately below the insertion of the psoas and iliacus 
muscles, or even at the middle of its shaft, the fragments of 
bone are drawn widely apart, owing chiefly to the traction of 
the muscles named above." 

Again, he says — u The patient lying on his back, we feel 
the distal end of the upper fragment of the femur pointing 
to the forepart of the thigh ; indicating that the axis of that 
part makes a more or less acute angle with the axis of the 
lower fragment."* This, be it observed, is as we commonly 
find the limb before anything is done to it; when it is not 
even laid straight in bed. And what, I ask, would be the 
effect to lay it straight, and thus confine it, as is done in 
using Desault's splint ? Would it, in the least, lessen the 
tendency of those muscles, of throwing the fractured ends 

* Note. — For quotations from "Maclise/'' I am indebted to T. S. BelL 
M.D., one of the Editors of "The Western Journal of Medicine and 
Surgery." See Western Journal t 3d Series, Vol. v., No. ii., Feb. 185Qv 



REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 97 

apart? or would it not rather increase that tendency? The 
answer is too plain to need any reply from me. Our a.uthor, 
u Maclise," very pertinently asks, too, " How, therefore, can 
we expect that the horizontal extension, whatever be the de- 
gree to which this is made, can be the means whereby the 
upper fragment is to be forced into a line of axis with the 
lower? Desault's splint does not effect this." 

Enough has now been written, surely, to show how very 
unmechanical in principle is the operation of the splint of 
Desault. And fortunate for the world has it been that the 
muscles of all are not equally endowed with irritability as the 
basis of excessive or morbid muscular contraction. I will 
now endeavor to point out how the indications in the treat- 
ment of fractures are to be correctly fulfilled ; and should I 
be allowed to give their order, I should say that it is the duty 
of the surgeon — 1st. To place the limb in such a position as 
thereby to relax those muscles which are chiefly concerned in 
displacing the fragments of the broken bone. In fractures 
of the femur, these have already been indicated ; while, on the 
contrary, those which are antagonistic will so act on those 
fragments as to give them an inclination, constantly, into a nor- 
mal line of that limb. I say, inclination — for it is only 
the inclination that we expect to give. The difference is cer- 
tainly immense, between an inclination to and an inclination 
from. Its limits cannot be measured — its consequences can- 
not be defined. In the one case, the broken ends will always 
be found in contact, and it only remains to give that part of 
the limb a sufficient degree of extension, when the fragments 
will, almost spontaneously, fall into a normal line, where they 
maybe retained usually without difficulty; itbeing only requir- 
ed of the surgeon to preserve his wonted position of the limb. 
In the other case, where the inclination is to separate, it is 
only by their meeting with such resistance in their course of 
separation as prevent them thereby from being thrown so 
widely apart as to leave no hope of a bony union. Maclise 
says, " though the fragments lie parallel, they are not placed 
end to end. In fractures of the upper third of the femur, it 



98 REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 

actually occurs that although to the outward seeming, the 
thigh corresponds in length and calibre with that of the op- 
posite and sound side, yet the two fragments of the bone may 
at the same time be drawn so far apart as that the broken 
point of the upper one may be felt subcutaneous at the fore- 
part of the limb, while that of the lower may rest deeply 
buried in the centre of the muscle ; and we have noticed such 
a condition of the parts to remain, even after the supposed 
reduction of the fracture, and the application of Baron Boyer's- 
screw splint," a modification of Desault's. 

It may be asked, perhaps, in what way is such a position 
of the limb to be given by the surgeon as to fulfil the first 
indication of the treatment? I answer — By the double 
inclined plane. By it the surgeon is furnished with the 
means of giving just such position as each individual case 
actually requires. That apparatus is useful for two purposes 
only ; one for the purpose of giving position — the other for 
the purpose of furnishing a bed to the limb, on which it may 
securely and quietly rest during treatment. It is not useful 
for the purpose of extension : herein, doubtless, has too much 
been confided to it. It is entirely incompetent of accom- 
plishing this end either in its simple, or in any of its modi- 
fied forms ; for this reason, that in its simple form all the 
traction which can be made to operate on the broken bone is 
derived either from the body of the patient, the lower portion 
of the limb being the fixed point ; or from the lower portion 
of the limb, the body being the fixed point ; but after all,, 
neither of them can be so fixed by the surgeon as that the pa- 
tient cannot materially modify them at his pleasure ; and I 
never saw an instance in which the patient did not so modify, 
not only the extending force, but also the position of the 
limb on the plane as to lose all the benefits of traction to the 
broken bone. In all of its modified forms, the traction ope- 
rating from the extreme ends of the limb, while that is at an 
angle (the leg with the thigh), the line of traction is consequent- 
ly not in the line of axis of the broken bone, but tends to cant 
the ends of those fragments forward out of that line. This 



REVIEW OF REMARKS ON THE USE OE JARVIS'S ADJUSTER. 99 

we conceive to be the reason why every modification of the 
double inclined plane has so uniformly disappointed the ex- 
pectations of the surgeon: many of them have been devised, 
which appeared exceedingly plausible at first view, but every 
one which I have examined (and I have seen very many) 
contained this defect ; and, as it appeared to me, was the 
chief cause of disappointment to the surgeon and his patient. 
These reasons against depending on the double inclined plane 
to furnish the necessary extension to the limb are not all that 
might be urged ; but they are plain, palpable, cogent, and 
sufficient for our purpose ; while for the purpose of position 
only, it is equally plain that it answers that end most per- 
fectly : but to do so, it is necessary that it should be so ar- 
ranged that the surgeon can vary its angle at pleasure while 
the limb is yet resting on it ; and can also vary the length of 
either position, without in the least disturbing the fracture 
of the limb, for the reason that it not unfrequently happens 
within the first few days of the treatment, that the surgeon 
discovers that he has not given the perfectly correct angle to 
the limb ; or that the thigh, or the leg portion of the plane, 
is either a little too long or too short for the limb to rest 
easy ; and he, therefore, wishes to alter it, so that the angle 
shall be correct and the patient easy without disturbing the 
fractured bone. This he can do with one arranged as above. 
Thus, too, he fulfils the first indication. 

2d. The second indication is, to coapt the fragments of 
the broken bone — or, in other words, to place those frag- 
ments in precisely the same relative position to each other in 
the limb as they occupied before the bone was broken, when 
they served to make up one entire bone. This is to be effect- 
ed by what is usually denominated extension and counter- 
extension ; or, in other words, by traction operating on the 
fractured portion of the limb, sufficiently, at least, to re- 
store it to its original length, when if the correct position be 
previously given, as described above, the fragments will at 
once, by the action of the muscles, fall into the natural line of 
that limb, generally without manipulation. 

This may be done either by assistants or by the adjuster; 



100 REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 

but the adjuster is the best for the following reasons : it is 
more gentle, more steady, more mild, and yet more power- 
ful, and consequently more efficient in its operation than the 
hands of the most perfectly trained assistants can be. It is 
generally less painful to the patient, and, besides, the sur- 
geon holds the power entirely in his own hand, and conse- 
quently he has it perfectly subject to his control. In short, 
he is thus made able, unaided, to perform the whole operation in 
a manner more satisfactory to himself and his patient than he 
could possibly do by assistants. It frequently happens that 
he is able to coapt the fracture more accurately than he can 
do under traction derived from trembling and fatigued hands. 
It is plain, therefore, that the adjuster is the best for this 
purpose ; yet these are not all the reasons why it is best. 
When a fractured limb is reduced by the adjuster, in doing 
so, the limb is thereby put under the influence or use of the 
proper apparatus by which to preserve coaptation, so that 
what has hitherto been held as distinct parts of an operation 
(viz., first, adjusting the fracture ; second, dressing the limb), 
now becomes but one. By the very means we coapt the frac- 
ture, we dress the limb. To those who have experienced the 
trouble which not unfrequently attends, of preventing dis- 
placement from a most perfect coaptation while the limb is 
being dressed, this privilege will be thought of no small con- 
sideration. 

3d. The third indication is to preserve the coaptation of the 
broken fragments, or, in other words, to maintain the same 
relative position of those fragments in the limb, which they 
occupied when the bone was entire, until they shall again con- 
stitute portions of an unbroken bone by natural reparation. 

The limb being kept at perfect rest in that correct position 
described above after the fracture is adjusted, it will readily 
be seen that there is but one cause remaining by which those 
fragments can be displaced. And was it not for this one 
cause, as all experience shows, the surgeon's task would be 
comparatively easy. It is against this one cause, then, after 
placing the limb and adjusting the fracture, that we are chiefly 



REVIEW OF REMARKS ON THE USE OP JARVIS'S ADJUSTER. 101 

to guard ; and it is mainly on account of this that we feel 
such solicitude in adapting our dressings. This cause is, the 
tendency of one, two, or more of the muscles of the limb to con- 
tract ; for it is seldom that the whole are found to contract 
at once, perhaps never. Indeed, the undue contractions of 
any muscle, so as to derange the fracture, is not an invariable 
attendant on a broken bone. But yet it is true, as a rule, 
that it is by a greater or less tendency in the muscles to un- 
due contraction that a limb is made too short after having 
been fractured. And that this tendency had not been effect- 
ually resisted — the contraction not overcome — and is, there- 
fore, the chief cause of many existing deformities, it is only 
necessary to examine those cases which have been treated on 
the double inclined plane alone, and in which this tendency 
to muscular contraction did exist, to show this to be one of 
the most prominent causes of deformity in fractures. 

I have already alluded to the means by which this tendency 
to muscular contraction may be effectually resisted — or, in 
other words, how coaptation may be accurately preserved ; for, 
in fact, as I have already shown, it is chiefly in preventing 
the muscular contractions of a broken limb that coaptation is 
to be maintained. I will now give the reasons for preferring 
the adjuster for this purpose also. 

First. — When it is correctly applied to a limb, the line of 
traction always operates on the fractured bone in the pre- 
cise line of that portion of the limb which is broken — the only 
correct line of traction ever set up in a fractured limb — nor 
can it ever deviate from that line, unless by the carelessness 
or unskillfulness of the surgeon ; he fails to secure his instru- 
ment perfectly in its proper place. 

Second. — This line of traction, too, is always kept within 
the limits of the fractured bone, beyond which, traction 
should never be made to operate. It never should involve in 
one line more than the part between any two contiguous joints. 

Third. — If at any time the muscles of the broken limb 
cease their contractions, the traction of the instrument also 
ceases to act on the limb ; but the moment they attempt to 



102 REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 

contract so as to shorten the limb, that moment are they re- 
sisted by the adjuster so that they cannot shorten it. 

Fourth. — When skilfully applied, it is found to be the easiest 
dressing for the limb which has hitherto been found. This 
must, however, as all will readily see, depend on the skill of 
the surgeon applying it. Indeed, it is with this in all re- 
spects as with every other surgical instrument ; very much of 
its success, when put to use, depends on the skill of the indi- 
vidual using it. If he does not know how to apply it, or to 
use it when applied, confessedly simple as it is to all who do 
understand it, he is quite liable to make a balk in the attempt. 
If he does know, he is ordinarily quite as sure of success ; 
for the simple reason, that his treatment is in all respects con- 
formed to well known and well defined principles in thera- 
peutics. 

It is no less the duty of surgeons to understand the ad- 
juster, and to use it too, in cases where it is plainly to be 
preferred, of which I allow them to be the judge, than it is 
mine to perfect it ; for it has been shown, I trust, that each 
individual indication in the treatment of fractures of the 
femur, as well as all of them collectively, can be correctly ful- 
filled by it — a truth, which no one can assert of any other 
apparatus in use, unless we except, perhaps, the apparatus of 
M. Baudens at the Yal de Grace Hospital, in Paris — but 
which, however, I should judge to be adapted only to hospi- 
tal practice. 

In addition to the above, however, for the purpose of pre- 
serving coaptation, it should be observed that the necessary 
splints and bandages are not to be neglected. (Of splints, I re- 
gard/eZ£ as the best, although I have more generally used wood.) 
Much may depend on them in giving necessary firmness and 
support to the injured parts ; and, indeed, the bandage, when 
smoothly and skilfully applied, assists greatly in preventing 
those muscular contractions of which I have already spoken. 

I have been thus particular in stating the plain and pal- 
pable objections which lie against the straight splint of De- 
sault, and all its modifications — the double inclined plane 



REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 103 

(for the purposes of traction), and all its varieties ; while I 
have as faithfully endeavored, without exaggeration, to set 
forth the benefits of the adjuster, as they really will be found 
to exist on being reduced to practice. 

When my lectures on fractures and dislocations were pre- 
pared, which were delivered at the Royal Westminster in Lon- 
don, I could do no more, for want of time, than to lay down gene- 
ral principles of treatment, and to give general rules for the 
application of the adjuster, and to give a description of its appli- 
cation in all the leading operations which it was intended to per- 
form ; and this I trust I have done, presuming that with the 
educated surgeon this would be quite sufficient to enable him to 
apply those principles, and to adapt those rules to particular 
cases as they should arise : I had a right to presume the surgeon 
to know something, and if I gave those general principles and 
rules so plainly that he could apply them, it was all that could 
be asked of me, while it is quite obvious it would be his 
duty to understand them. With very many, indeed, with all 
as far as I know, who have made it a principle with themselves 
to understand the application of that instrument in all its 
varieties, I am gratified to learn, as I have, that those general 
instructions have been quite sufficient to enable them to apply 
the instrument to particular cases, especially after having 
been shown its application by the agent as they generally are. 
It would be quite impossible for me to give a description of 
its application in every conceivable case ; indeed, I could not 
conceive of all the varieties which might occur, and, besides, it 
might take volumes to describe them all, and yet, to the intel- 
ligent surgeon, they would be of very little value. He might, 
after all, be obliged to tax his own knowledge for the best 
mode of its application. These are the principles, and there 
are the facilities — and it is his duty to be able to apply them. 
Some there are who, having found the variety of its applica- 
tion so much greater than I had given them (not understand- 
ing fully my design), that they have said "the half I had 
not told;" while there are others who seem not to be able 
to go one step beyond what is laid down ; and some, indeed, 



104 REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 

there are who appear not to be able to do even that. I have 
been not a little amused at seeing the variety of talent in the 
profession ; for I have been greatly favored with opportuni- 
ties for observation, and I could not but improve them to 
some extent. 

In reply to Dr. Haines's statement, that "the instrument 
fails in its applicability to all cases, because it does not ad- 
mit of modifications which different cases seem to call for," 
I would merely say that I presume it will not be questioned 
that I have seen very many cases for the treatment of which 
kind of injury the adjuster was arranged, and that I now 
state for the benefit of all that I never saw one where the 
adjuster could not be readily applied in the treatment ; and 
that I once applied it to a compound fractured limb of a child 
four years old (and I can see no difference in applying it to 
one of two and a half and one of four years old), with the 
very happiest results. The length of the instrument did not 
embarrass us, and its weight was a decided benefit in the 
treatment — not an ounce of which ever falls upon the limb ; 
but by its lying parallel with the limb, while that is securely 
attached to the instrument, the limb is thus held perfectly 
still by the weight of the instrument lying by its side. I was 
perfectly delighted, on one occasion, to see the little fellow 
throwing the sound limb about in all directions, himself per- 
fectly happy and undisturbed, while the fractured limb lay 
entirely motionless on the plane with the adjuster by its side. 
He early learned that he could not move the limb, and he, 
therefore, did not attempt it. Nor was the instrument by 
which he was confined the least burden to him. The wound 
healed and the bone united in a very short time, I should 
think not to exceed a month or five weeks, when he was about 
the house ; and if any one will now tell, unaided, which was the 
fractured limb (unless the scar leads them to detect it), I 
will acknowledge that I do not know when a limb is correct. 
Will Dr. Haines allow me to suggest how he could have 
dressed the limb of his little patient ? Suppose he had had 
prepared for the occasion a small double inclined plane which 



REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 105 

fitted the limb in length, and the fracture in angle, and of 
width sufficient (after being well padded) to lay the limb and 
instrument on it ; then suppose, instead of the large thigh 
fork, he should have used the jointed-fork with the instrument 
placed on the outside of the limb, on the plane ; and suppose 
also he should have used a small but well-stuffed perineal 
band, or roll, which could have been made in a very few mo- 
ments, for the occasion, by any lady who understood the use 
of the needle ; the ends of this roll to be secured around 
the arms of the jointed-fork, an arm lying on either side 
(back and front) of the pelvis ; and now, to seize and secure 
the limb to the foot of the rack-bar, suppose he had used a 
silk handkerchief, and with that apply the Jarvis hitch to the 
limb immediately above the knee, and thus secure the limb to 
the instrument, I believe the application would not have 
been difficult, and the result the same as in the case of my 
little patient. 

Instead of the jointed-fork, it is sometimes better to run 
out the counter-extending bar, and secure the ends of the roll 
to that, or to fit a small piece of iron or wood in form of a T, 
the stem to be received into the socket of the counter-bar, the 
ends of the roll to be made fast to the arms of the T. Care 
should be taken to place folds of cotton or woolen cloth under 
the handkerchief on the two sides of the limb. In short, 
in treating a fracture, very much depends on the gentleness 
of the mode adopted of seizing the limb and securing it to 
the instrument. In treating a fracture, I never use the roll or 
belts which accompany the instrument. The first I always 
have prepared for the occasion, minding that it be always 
well stuffed ; it does not require to be very strong ; one piece 
of common webbing with cotton cloth stuffed in form of a 
roll and tacked to the webbing is quite sufficient — and for 
belts, a common cotton roller applied round the limb over the 
pads, with tapes in the coils of the roller on each side of the 
limb and directly over the centre of the pads, is just as good 
as to use the perineal band and the belts. They are made 
very strong to be used in dislocations ; they should not, there- 



106 REVIEW OF REMARKS ON THE USE OF JARVIS'S ADJUSTER. 

fore, be used in fractures where but little strength is required, 
lest their own strength become impaired thereby. * * * 
Dr. Haines's case was by no means a singular instance of the suc- 
cessful use of the adjuster in ununited fractures ; I have myself 
seen it used in several such instances, one of which is reported 
in the Boston Medical and Surgical Journal ; and if I recol- 
lect rightly, I there gave what I thought to be the reasons 
why we succeeded with the adjuster, and why we did not with 
the other means. Its utility, however, is by no means con- 
fined to ununited fractures. The child of four years old was 
a beautiful illustration of its value in other cases. Indeed, 
seldom a week passes that I do not know or hear of some 
important application of that instrument ; even while writing 
this, a young gentleman has called on me, from one of the 
hospitals, and states to me that they recently had in the 
hospital a dislocation of the head of the femur into the ischi- 
atic notch, and after having failed with other means, they 
reduced it by the adjuster. In relating these instances, my 
object is not to publish cases ; it never has been ; I disdain to 
use such means for the purpose of bringing it into favorable 
notice. What I have written pertaining to it, at any time, 
has been for the purpose of communicating information which 
I thought might be valuable to the profession, yet that it has 
won the favor and confidence of many I am well assured. 
Portland, Conn., August 23, 1850. 

[Note. — The remainder of Dr. Jar-vis's essay is principally 
devoted to the discussion of the question, whether (as has 
been declared " by a certain Medical Society") " it is dero- 
gatory to a physician to hold a patent right for any surgical 
instrument." As the discussion of this subject does not in 
anywise bear upon the merits of the adjuster, we think it 
irrelevant to the point at issue. Dr. Haines's objections to 
the " adjuster" are not founded upon the fact that it is 
patented ; he speaks of it only as " the adjuster, invented 
and patented by Dr. Jarvis," and as having a " patent instru- 
ment" placed in his hands by an agent, which he applied, and 



mulford's forensic medicine. 107 

by which, lie was " enabled readily to maintain the length of 
the limb," &c. As Dr. Jarvishas thought his instrument un- 
justly treated of by one of our correspondents, and through 
the columns of our Journal, we have allowed him a fair oppor- 
tunity for defence through the same medium, having published 
so much of his essay as relates to the "adjuster" itself; 
omitting such parts as we considered personal. We express 
no sentiment as to the justness of Dr. J.'s comparison between 
the patent-right and copy-right law, and we are silent upon 
the subject, because we do not wish to open our pages to un- 
profitable controversy. — Ed.] 



FORENSIC MEDICINE IN NEW JERSEY. 

BY ISAAC S. MULFORD, M. D. 

The relations existing between medicine and other branches 
of knowledge are various, and oftentimes intimate. At some 
points these relations become so close as to give rise to a 
union of elements, and the consequent establishment of new 
and special departments of science. Among the most im- 
portant, as well as best known examples of this description, 
is the union that takes place between medicine and law, giv- 
ing origin to the science usually denominated Medical Juris- 
prudence or Legal Medicine. By the liberal inquirer in 
medicine, a knowledge of the department of study just men- 
tioned will always be desired ; inasmuch as, by acquirements 
of this nature, his own reputation, as well as the dignity and 
usefulness of his profession, may often be greatly advanced. 
Under this impression in regard to its importance, the opinion 
has been formed that some notice of this subject might not 
be deemed improper or inappropriate. 

Differences are found to exist in the science in question on 
account of the varying regulations of different countries, and 
vol. iv. — 12 



108 mulfobd's forensic medicine. 

States. Being precluded from a general notice, the purpose 
in view at this time is merely to examine, in a general way, 
the condition and character of legal medicine as now existing 
in the State of New Jersey. 

The several subjects that are embraced in Forensic Medi- 
cine, so far, at least, as they will now be brought into notice, 
may be considered under two divisions or aspects. First — 
such as are special in their bearing, having a relation to indi- 
vidual cases ; and Second — such as are general in their cha- 
racter, referring to communities at large. 

The limits allowed at this time for the consideration of these 
subjects are so narrow, that little more will be attempted than 
merely to advert to some of the most important particulars ; 
to bring into view the regulations existing in our state in re- 
gard to them, and to indicate such questions as will be most 
likely to arise in the course of forensic inquiry. 

According to the division of the subject just mentioned, 
notice is first to be taken of specific cases in which particular 
individuals alone are involved; and among such cases, those 
in which there has been a direct infliction of personal injury 
may be regarded as the most important. Personal injuries 
may be of such a nature that they may only affect the con- 
dition of the subject with respect to his appearance, his actions, 
or his enjoyments ; or, they may be destructive to life, prov- 
ing fatal in their consequences, either immediately or ulti- 
mately. Of the minor description (without pausing to enter 
upon a notice of wounds of a slighter character), attention 
may be directed to a numerous class of injuries usually de- 
signated by the terms demembration, mutilation, or mayhem. 
Inflictions of this kind are extremely various, not only in 
regard to the seat of the lesion, but also as to the effect upon 
the state of the person ; and hence, in many codes, a strict 
discrimination has been made, either by placing the offence 
according to circumstances, in different grades of crime, or 
by affixing specific penalties to each one. 

Distinctions of this kind are not drawn in the code of our 
State, though within certain limits discretion is allowed, so 



mulford's forensic medicine. 109 

that tlie punishment may be proportioned according to the 
offence. The statute of New Jersey applying to cases of this 
description prescribes, that " if any person from deliberate de- 
sign shall cut out or disable the tongue ; put out an eye ; cut off, 
or slit a lip ; cut off, slit or destroy the nose ; or cut off or dis- 
able any limb, or member of another ; he shall, upon convic- 
tion, be deemed guilty of a misdemeanor, and be punished by 
imprisonment at hard labor for a term not exceeding seven 
years, or by a fine not exceeding one thousand dollars, or 
both." By our law, then, the perpetration of an injury of this 
kind is in no case considered as more than a misdemeanor, 
and the offender is only liable to punishment by fine and im- 
prisonment. In many other codes the provisions are more 
rigid, several of the offences mentioned being considered as 
felonies. In some instances, the malicious mutilation of a 
man by castration is considered a capital offence, and this is 
the case in two of the States of our Union. But in our State 
the general features of criminal legislation, in almost all in- 
stances, are comparatively lenient. 

The medical testimony usually required in cases of mutila- 
tion may be easily given, being generally merely of the cha- 
racter of common description. But in some instances, a de- 
gree of precision in anatomical and surgical knowledge will 
be demanded, in order to determine in a satisfactory manner 
the extent and the consequences of particular wounds. The 
actual injury done in attempts at castration may be various. 
The concealed situation of the organ, especially when involved 
with a hernial protrusion ; a morbid enlargement of parts, or 
a collection of fluid, might occasion the infliction of a hurt 
very different, and, perhaps, even more grievous, than the 
one designed. And in other cases, the complicated relations 
of parts will sometimes involve results which no ignorant or 
inexperienced observer would be likely to apprehend or be 
able to explain. 

Another injury belonging to the division now under notice, 
is that which is committed in cases of forcible violation. In 
its purely physical aspect this may be regarded as less grave 



110 mtjlford's forensic medicine. 

in its character than many other offences within its class, but 
it becomes of the highest importance from the moral consi- 
derations with which it is always connected; and hence, in 
most civilized communities, it has been made the subject of 
careful legislation, and in no case is strict legislation more 
fully supported by popular feeling. 

The statute of New Jersey provides, that " any person who 
shall have carnal knowledge of a woman against her will, or 
who shall aid, abet, hire, or procure any person to commit 
such offence, or who, being of the age of fourteen years, shall 
know and abuse any woman child under the age of ten years, 
with or without her consent, shall, upon conviction, be adjudged 
guilty of a high misdemeanor, and be punished by fine not 
exceeding one thousand dollars, or imprisonment for any term 
not exceeding fifteen years, or both." It will be observed 
that a distinction of cases is here made, founded upon age, 
the maturity of the party being made an important point : 
above the age of ten years it is supposed that such a degree 
of maturity will have been reached as to qualify for the exer- 
cise of discretion and will ; and then, in order to the perpe- 
tration of the crime in question, it must be committed against 
the will of the subject, as assent on her part would modify 
the nature of the offence. But below the age of ten years, 
the subject is not supposed to be capable of such an exercise 
of discretion and will in the case as would change the cha- 
racter of the crime, and hence, in such instances, the mere 
commission is made sufficient without any regard whatever to 
the volitions or acts of the subject. The particular limit 
marking legal maturity in this case varies somewhat in differ- 
ent codes, the variation being probably determined in some 
degree by the effect of climate upon the development of the 
human system. In some instances it is eleven years, in 
others twelve, and in a few it is yet higher. A distinction 
is also made in law with regard to the age of the offender. 
Below the age of fourteen years, it is assumed that there is a 
want of capacity for committing the offence, and hence no 
one earlier than this can be convicted of it. But this limit 



mulford's forensic medicine. Ill 

also varies in a similar manner as the one before noticed. 
The punishment prescribed for this crime differs much in dif- 
ferent countries. In some, it is death ; as is the case in 
some of the United States ; and it is so in several others of 
them, where the offence has been committed by a negro or 
mulatto against a white female, and very recently capital 
punishment has been inflicted upon such an offender. In 
some instances, the punishment directed, is such a mutilation 
of the perpetrator as will render him afterwards incapable of 
a similar offence. It is not unusual for different degrees of 
punishment to be prescribed when the injury has been done 
to a female of tender age, and when committed against one 
who has arrived at maturity. In our law, as has been seen, 
no distinction of this kind is specifically made. 

Various medico-legal questions may arise in the investiga- 
tion of cases of this nature. The proof mostly rests in a 
great degree upon the testimony of one individual, and that 
one a party; yet the atrocity of the crime renders it of im- 
portance that the guilty should never escape, and hence the 
testimony of the injured person is considered sufficient (unless 
'impeached) to convict the offender. Yet the opinions of me- 
dical witnesses are frequently required either to resolve doubt, 
to expose error or falsehood, or to place truth in a clearer 
and stronger light, in order that full justice may be done, both 
to the accuser and the accused. A full knowledge of the 
physical signs which denote the reception of such injury by 
the female, and of the circumstances which distinguish it 
from all others, will hence be required. Upon the question 
of violence, it may sometimes be necessary to determine 
whether the wrong in question may be committed without the 
consciousness of the subject ; in other words, whether uncon- 
sciousness to it could occur from the effect of narcotics, the 
influence of terror and exhaustion, or from ordinary sleep. 
Other questions formerly much agitated, touching the precise 
extent of the infliction, are not now regarded as of principal 
importance, the extremest injury not being made necessary to 
constitute the offence. 



112 mulfokd's forensic medicine. 

A careful regard to human life has led, in most States, to 
the enactment of penal statutes for the prevention of such 
practices as are designed to disturb or interrupt the process 
of gestation. Laws upon the subject of criminal abortion 
have long been considered as an important portion of criminal 
codes. But in our State no such enactment has yet been 
made, the provisions of the common law having been solely 
relied upon. In many instances, the common law may afford 
a resort sufficiently applicable and ample, but in the present 
case it is defective. Beside its want of precision, it would 
seem to proceed upon views that are no longer acknowledged 
as just and sound ; it recognizes very material differences in 
the grade of the offence, according to the particular period 
of its commission. It has been held, according to this code, 
that no act producing abortion was an indictable offence pre- 
vious to the period of quickening. This view was, no doubt, 
predicated upon the idea that at the time mentioned, the 
foetus became endowed with the principle of vitality, and was 
thenceforward to be considered as having distinct existence, 
though being until then no more than a part of the mother. 
But this doctrine is no longer entertained. Quickening is not 
now supposed to mark any special change in the character or 
mode of foetal existence, and it is known that vitality existed 
at a far earlier period. 

As might be expected from the prevalence of more correct 
physiological opinions, a sense of the importance of correct and 
distinct provisions by statute has been manifested ; and 
hence, at the late session of our legislature, a special enact- 
ment upon this subject was projected. In this, no distinc- 
tion was admitted on account of the period of gestation, but 
the bill as presented was not thought to be sufficiently consi- 
dered in other respects, and, therefore, finally failed. 

Where the offence in question is committed after the period 
of quickening, whether it be done by administering any potion, 
or by blows or other violence, it is said by authorities to be 
a great misprision, but not murder, unless the child be born 
alive. Where the child is born alive, and afterwards dies 



mulford's forensic medicine. 113 

from injuries received, it is murder, according to most authori- 
ties ; and so it has been held to be, if the mother is destroyed. 

In these cases, the medical witness may have to distinguish 
between the effects of any unlawful proceeding, and the influ- 
ence of natural causes, and the proofs which go to establish 
the fact of a recent abortion may also be required. 

The subject of Infanticide may next be considered. Not- 
withstanding its revolting character, the degradation and the 
vices of communities have rendered this but too frequent an 
offence. In ancient times, indeed, from the prevalence of 
ignorance, superstition and cruelty, this practice was freely 
tolerated, and even sometimes encouraged. Modern nations 
have freed themselves from this stain, and in most instances 
have prohibited the practice by positive penal enactments ; 
yet, if national morality has been vindicated, individual in- 
stances of crime have not been prevented. 

The statute of New Jersey relating to infanticide partakes 
of the leniency that is characteristic of our penal legislation 
in general. In truth, however, the provisions of our law 
have but an indirect and collateral application to the offence 
in question, their direct bearing being upon other and minor 
offences. The law prescribes, " that if any woman shall con- 
ceal her pregnancy, and shall willingly and of purpose be 
delivered in secret by herself, of any issue of her body which 
shall by law be a bastard, every such woman shall be ad- 
judged to be guilty of a misdemeanor, and on conviction shall 
be punished by fine not exceeding one hundred dollars, or by 
imprisonment at hard labor, for a term not exceeding four 
months, or both. And furthermore, that if any woman shall 
endeavor privately, by drowning, or secret burying, or in 
any other way, either by herself or the procurement of others, 
to conceal the death of any issue of her body, which if born 
alive would by law be a bastard, so that it may not come to 
light, whether it were born alive or not, or whether it were 
murdered or not, she or her abettors shall be adjudged guilty 
of a misdemeanor, and on conviction shall be punished by 
fine not exceeding two hundred dollars, or by imprisonment 



114 mulford's forensic medicine, 

not exceeding one year, or both." It will be observed, that 
the operation of this law is limited to eases of bastardy, pro- 
ceeding, it may be supposed, upon the presumption that the 
crime in question will not be committed except in such in- 
stances, But it is certain that examples have occurred of 
married women, living with their husbands, being arraigned 
and tried for child murder. 

The particular nature of the offences contemplated in the 
statute will also be noticed. The mere concealment of preg- 
nancy and delivery is made punishable, though no other evi- 
dence should exist or be apparent as to any designs or acts 
of a criminal nature. So also the disposing of the body of 
the child for the purpose of concealing its death, or to obscure 
or render doubtful the manner of its death, will subject the 
actor or actors to the penalties prescribed. In some ancient 
codes, the offences here specified were considered as equiva- 
lent to child murder, and parties guilty of them were capitally 
convicted ; but this cruel presumption is now almost univer- 
sally rejected. 

But it would seem extraordinary that, in our law, the actual 
destruction of the child remains without any express notice. 
Cases might occur in which attempts at concealment had not 
been made, or if made had failed, but in which the evidences 
of criminality might become sufficiently clear. For such in- 
stances no remedy is here given. A proceeding, however, as 
for the crime of murder, might still be resorted to, founded upon 
provisions existing elsewhere. Various questions of no little 
interest may arise in examinations relating to this offence. 
Some of these will be of less importance when the inquiry 
is confined, as under our law, to the mere question of conceal- 
ment. Here, the principal points would be, to determine 
the facts of pregnancy, delivery, and the disposal of the body 
of the child. But where the charge is for actual child 
murder, the case would become one of higher importance, 
as well as of greater intricacy. It will then be necessary to 
inquire concerning the age of the child, as it may possibly 
be so immature as to be incapable of distinct existence 



mulford's forensic medicine. 115 

as a living being. If it should appear to have been ca- 
pable of living, the question will arise, whether it had actu- 
ally been born alive ; a question that requires for its full 
determination an ample measure of knowledge, as well as 
patient and close attention. Should it be determined that 
the child was alive at the period of its birth, the causes of its 
death will remain to be determined, whether the loss of life 
was owing to anything that was natural or avoidable, or had 
been produced by injuries wilfully inflicted. 

The subject of Homicide may next be brought into notice. 
Homicide is usually considered as being of several kinds or 
grades. In some of our legal works it is divided into justi- 
fiable, excusable and felonious homicide. It is justifiable 
when committed under circumstances of unavoidable or ex- 
treme necessity, as in the proper enforcement of legal authority, 
or in the defence of life, of chastity, or of home. It is re- 
garded as excusable when committed in a purely accidental 
manner, as when a person is in the pursuance of his usual 
business or enjoyments, and there falls out, without any cul- 
pable negligence, some misadventure which causes the loss of 
life in another. These varieties of homicide do not fre- 
quently become the subject of forensic examination, and may, 
therefore, be passed over without particular attention. But 
in the other variety, felonious homicide, there is always some- 
thing of a criminal character, though even here the degree of 
criminality is not always the same. There are cases designated 
as felo de se in which the individual becomes a felon towards 
himself by committing self-destruction. Here, although the 
act is one of high criminality in many respects, it is scarcely 
within the reach of human enactments ; and, therefore, only 
becomes the subject of legal examination in order to deter- 
mine what the real nature of the case may be, in order to 
distinguish between suicide and homicide ; a matter in some 
instances of exceeding difficulty. When committed against 
another, felonious homicide may be perpetrated in a manner 
that will mitigate in some degree the enormity of the crime. 
This will be the case when it is done without any premedi- 



116 mulford's fokensic medicine. 

tated design to kill, but yet in the prosecution of some im- 
proper or unlawful course, in which the actor will become 
responsible for any mischief or wrong that may ensue. This 
is manslaughter. 

The highest grade of felonious homicide is that which, in 
common language, is called murder. Murder, it is said, is 
where a person of sound memory and discretion unlawfully 
killeth a reasonable creature in being, and in the peace of the 
State, with malice aforethought either express or implied. 
By the law of New Jersey, this offence is divided into two 
degrees. 

Before proceeding further, it may be proper to take notice 
of the particular conditions that must exist, in order to the 
commission of the offence in question. These conditions have 
been specially mentioned in the definition of murder, though, 
with a single exception, they do not peculiarly relate to that 
grade of crime. 

The offence can only be committed, so as to involve re- 
sponsibility, by a person of sound memory and discretion. 
In what, then, does this soundness of memory and discretion 
consist ? or what kind or degree of unsoundness will place the 
individual beyond the limit here laid down ? These questions 
are entitled to careful attention. Two descriptions of persons 
are mentioned in our laws as being exempted from punish- 
ment on account of incapacity of mind. These are, infants 
and lunatics. 

But the terms infant and lunatic are liable to be variously 
understood and interpreted ; and hence, it is necessary to in- 
quire as to their precise signification in connection with the 
subject in question. In a civil sense, all persons are con- 
sidered infants until they attain the age of twenty-one years, 
but this is not the case in a criminal sense. In the latter 
respect maturity is reached much sooner. It has been laid 
down as a general rule, that on the attainment of fourteen 
years of age, the criminal actions of infants are subject to 
the same modes of construction as those of the rest of society. 
But children have been convicted of crimes, and of capital 



mulford's forensic medicine. 117 

crimes, at a much earlier period than this ; cases are upon 
record showing that capital punishment has been inflicted at 
the age of ten and even of nine years. Below the age of 
seven years there can be no guilt of a capital offence ; between 
seven and fourteen, cases are to be determined upon accord- 
ing to particular circumstances, the degree of capability not 
being always to be measured or estimated by the number of 
years alone. In Hunterdon county, in this State, a boy aged 
twelve years and five months was tried upon an indictment 
for murder, and was convicted and executed. In another case 
in our State, a boy aged ten years and ten months was tried 
for murder and found guilty. In the latter case, the Chief 
Justice, Kirkpatrick, remarked that "it is perfectly settled 
that an infant below the age of seven years cannot be pun- 
ished for any capital offence, whatever circumstances of mis- 
chievous intention may be proved against him ; for by pre- 
sumption of law he cannot have discretion to discern between 
good and evil ; and against this presumption no averment can 
be admitted. It is also perfectly settled that between the 
ages of seven and fourteen years, the infant shall be pre- 
sumed to be incapable of committing crime upon the same 
principle ; but then this presumption may be encountered by 
proof, and if it shall appear by strong and irresistible evi- 
dence that the individual had sufficient discernment to distin- 
guish good from evil, to comprehend the nature and conse- 
quences of his acts, he may be convicted, and have judgment 
of death." 

The subject of Lunacy is one of far greater difficulty. 
Under this term there have been included together a number 
of mental affections which differ in many of their features ; 
and in order to arrive at conclusions at all satisfactory, it is 
necessary that some discrimination should be made. 

By a proper attention to the causes, the forms, and the de- 
grees of mental disorder, the observer will be enabled to 
arrange the cases that may be presented to notice, into dif- 
ferent classes or groups. One of these classes will consist of 
cases in which the affection is traceable to some congenital 



IIS mulford's forensic medicine. 

infirmity. The individuals have been idiots from birth, a fault 
having existed in the original conformation or condition of 
the organ of mind. Such a state is signified in medical phrase- 
ology by the term amentia. Here there is no capacity to 
acquire a proper knowledge of the distinctions between right 
and wrong, in principles and in acts, and of consequence 
no accountability will attach to anything attempted or done. 
A state very similar to this, in most respects, may be pro- 
duced at later periods by injuries to the head, or may occur 
as the effect of different diseases — the marks of idiotcy are 
usually sufficiently clear. In ancient books, it is said that he 
is an idiot "who from his birth cannot count or number twenty 
pence, nor tell who was his mother, nor how old he is ; but 
if he have sufficient understanding to know and understand 
his letters, and to read by teaching or information of another 
man, then he is not an idiot." But this may be considered 
as an extreme picture. Commonly the deficiency is by no 
means so great. In many instances idiots have memory, and 
may be instructed to a limited extent. But if some informa- 
tion may be imparted to them, there is a want of understand- 
ing to turn it to use, the mind being imbecile or sterile. Insane 
men often reason acutely though erroneously, but idiots do 
not reason at all, not being possessed of the power ; and no 
one who is void of the power of reasoning can be guilty of 
any crime. 

In another class of cases there has been the usual develop- 
ment of mind, but it has become affected with general de- 
rangement. The mind is disordered in all its faculties, and 
in consequence the individual is rendered incapable of order- 
ing his actions aright in any respect, or of judging truly upon 
any subject. This is mania. During the existence of this 
state, no one will entertain the idea that the individual is at 
all accountable for any of his deeds. But mania is some- 
times susceptible of cure, when the mind will return to its 
former condition; and in other instances, though a positive cure 
has not been effected, there will yet be intervals of sanity, and 
a great degree of melioration takes place. These lucid inter- 



mulford's forensic medicine. 119 

vals, when of frequent occurrence, were formerly thought to 
be referrihle to lunar influences, and hence the terms lunacy 
and lunatic. Whether this opinion has any foundation in 
truth, or is to be regarded as only a fanciful notion, it may 
not be necessary now to inquire ; it is in anywise certain that 
mania is not a state of uniform fixedness,' but is liable to 
much variation. It is this circumstance that frequently gives 
rise to doubt and embarrassment in courts, the actual condi- 
tion of the party arraigned being rendered uncertain. The 
mere existence of insanity at previous periods, or even subse- 
quent periods, will not be conclusive ; there should be reason 
to believe that it existed, and influenced the party at the 
time of the commission of the offence, and in its commission. 
But a general state of insanity having been shown, the bur- 
den of proof, as to the existence of a lucid interval at the 
particular time in question, will be thrown upon the opposite 
party. What then is such an interval of sanity as must be 
shown to exist? As to its duration, it must be sufficient to 
allow not merely of a transient gleam, but of the continued 
enjoyment of consciousness, so that there may be a know- 
ledge of the actual and relative condition of the party at the 
time. 

As to the extent of the amendment, different opinions have 
been held. Some have maintained that it is necessary that 
the person should have recovered in every respect his former 
habit and state of mind ; whilst others consider it sufficient, 
if he has come to possess a capacity to distinguish between 
right and wrong, and to know the nature and the conse- 
quences of the acts in which he may engage. The latter 
view is that which seems to be supported by the greatest 
weight of authority. The opinion is, that if an individual, 
arraigned for the commission of a criminal act, was at the 
time of its commission capable of discriminating between right 
and wrong, not generally merely, but in reference to the very 
act in question, he may be held responsible, though in some 
respects his mind may not be in a perfectly natural state. 

There is another form of insanity which frequently becomes 



120 mulford's forensic medicine. 

the subject of inquiry in the course of legal investigation. 
In this the derangement is limited to some one particular sub- 
ject or point. This is monomania. In cases of this kind the 
mental operations may be performed in the usual manner 
without any appearance of disturbance until a particular limit 
is reached, and then immediate disorder will occur. But this 
limit may vary. Sometimes it exists in the intellectual faculties, 
and the person will then adhere with steadiness to some erro- 
neous opinion or belief, whatever representations or evidence 
may be offered to the contrary. In other instances the intellec- 
tual faculties may entirely escape, the only trace of disordered 
action being found within the circle of the propensities, or 
the moral faculties: then there will be exhibited a perverted 
state of the feelings and inclinations, or morbid impulses, 
urging, it may be, to the commission of violent atrocious acts. 
Among such cases is the homicidal monomania, which in lat- 
ter times has been frequently brought into notice by medical 
authorities. 

Monomania has been urged, in many instances, as a plea 
of exemption from punishment, and hence its character in a 
medico-legal respect should be well understood. It has been 
seen that the habitual state of mind in cases of this sort is such 
as to admit of the exercise of reason in relation to subjects 
generally, and it may be supposed that accountability will 
exist to a corresponding extent ; in other words, that the in- 
dividual may be held responsible so long and so far as he has 
a knowledge of truth and error, of right and wrong. But 
when he comes to be under a belief which no reasonable man 
would entertain, then the acts which spring from such a be- 
lief must be regarded as insane acts, and consequently not 
punishable. 

The greatest embarrassment will occur in the consideration 
of cases in which there is no derangement at all of the rea- 
soning powers, but only a disordered condition of the propen- 
sities or sentiments. Here, if the morbid influence is so 
powerful that the subject is unable to resist it, if though rea- 
son acts, it no longer controls or can control, if the individual 



mulford's forensic medicine. 121 

moves from an impulsion which has become overpowering, he 
is not then the master of his acts, and involuntary acts can 
be attended with no responsibility. But such an extreme 
state will but rarely occur ; and whether it should be acknow- 
ledged at all, or whether its admission will tend to render the 
administration of justice in criminal cases more sure and safe, 
are points that divide, and will probably continue to divide, 
the opinions of jurists. In the present state of our know- 
ledge, however, it would scarcely seem safe to deny that such 
a condition of mind does sometimes exist. 

A form of mental disorder which is produced by indul- 
gence in spirituous drinks is frequently brought into notice in 
connection with the commission of crime. Intoxication is 
mostly attended by a sort of mental alienation, temporary in 
its duration, but oftentimes most perverting and brutalizing 
in its effects. But this disorder is not considered as forming 
any ground for a plea of exemption in cases of crime, inas- 
much as it has been voluntarily induced. It is regarded as a 
settled rule that when drunkenness is voluntary, it cannot 
excuse a man from the commission of crime, but, on the con- 
trary, must be considered an aggravation of the offence ; and 
this is so, because every individual must be held responsible for 
all that which flows immediately from his own deliberate acts. 

There is a more protracted affection of a kindred character 
as regards its origin, which it is also proper to notice, that 
which is usually called mania a potu. This disorder, though 
produced by indulgence in intoxicating drinks, is yet one of 
the remoter consequences, and a consequence which is not 
constant, or even extremely common. Hence it can scarcely 
be said to be wilfully incurred. The action of courts has 
varied upon the subject of this affection. In some instances 
its existence has been held to be a sufficient excuse for crimi- 
nal acts ; whilst in other cases, the plea has been wholly re- 
jected. But the weight of authority would seem, at the 
present time, to be in favor of entire exemption when the 
nature of the case is clearly determined. 

A word may be proper upon the question, whether there is 



122 mulford's forensic medicine. 

any general test or evidence of insanity by which its exist- 
ence may be determined in cases of doubt and obscurity. 
That which is most generally relied upon is the occurrence of 
delusions or false notions ; the fancying things to exist which 
have no existence, and which fancy no evidence can remove 
or correct. This test will no doubt hold good in numerous 
instances, and, perhaps, in all in which there is derangement 
of the intellectual powers. But where the understanding 
is clear, and the moral or affective faculties alone are in- 
volved, this test will entirely fail. In the latter case, there 
will be no delusion, no mistaking of things. Hence some 
authorities have refused to recognize a disordered condition 
of the propensities merely, as properly constituting a state of 
insanity. Lord Erskine says, " Delusion, therefore, where 
there is no frenzy or raving madness, is the true character of 
insanity, and where it cannot be predicated of a man stand- 
ing for life or death for a crime, he ought not, in my opinion, 
to be acquitted." 

But this is a more restricted view than is commonly taken, 
and some of the highest names, especially in the medical pro- 
fession, might be brought forward in supporting a belief in 
the occurrence of insanity affecting only the moral powers or 
animal propensities. Further remark may not be necessary 
in regard to the state of the mind. 

The other conditions that are reckoned essential in order to 
conviction of the crime of murder, need be noticed but very 
slightly. It must be perpetrated upon a reasonable creature 
in being, and in the peace of the State. By the former of 
these particulars, those cases are excluded in which an unborn 
child has been destroyed. An infant before birth is not con- 
sidered as a person who can be killed within the description 
of murder. A limitation of this rule, however, has been 
noticed when treating of child murder. By persons within 
the peace of the State, all are meant to be included^ except- 
ing only public enemies actually engaged in warlike operations. 

The only other condition to be mentioned is that which forms 
the foundation of the principal distinction between murder and 



mulford's forensic medicine. 123 

homicide, to wit: that the act be committed with malice afore- 
thought, either express or implied. 

A knowledge of the particulars and distinctions just noticed, 
is of importance in order to a proper comprehension of the 
several questions that will be likely to arise and to demand 
attention in the course of judicial investigations. 

It has been seen that homicide may be committed under 
circumstances that will serve to extenuate the offence. The 
principle of these, is the absence of everything that would 
indicate premeditated design. The act may be committed in 
a sudden, and heated encounter between parties, and a pre- 
sumption will then arise that no deliberate purpose had been 
formed. The same presumption may arise from the nature 
of the injury. A wound is inflicted which may be compara- 
tively slight, but, from the bad condition of the subject at the 
time, it is followed by a train of symptoms which terminate 
in death. Here no murderous design will be apparent, but 
as the act was unlawful, the actor is held accountable for all 
that may result from his proceeding. The only point will be 
to show an absolute connection between the act, and the result, 
a point, however, which in some instances is one not easily de- 
termined. An injury may be inflicted upon a person who is 
subject to, or is laboring under disease, and the question may 
be raised whether the death was owing at all to the injury, or 
was attributable to the disorder. In such instances, if the 
hurt received was of such a nature as might be expected in 
ordinary cases to produce a fatal issue, no other thing need 
be brought into notice. But if not, it is then to be considered 
whether the disease would have occurred and proved fatal 
at that time, had no hurt been inflicted. If this could 
not be supposed, the injury must then be allowed to stand in 
connection with the event, as a cause, or at least an occa- 
sion.* In a case that was tried in Burlington county, a 
blow had been inflicted upon the head, by which the skull 



* A cause is that without which a thing would not occur at all. An 
occasion is that on account of which a thing occurs at a certain time. 
VOL. IV. — 13 



124 mulford's forensic medicine. 

was fractured, and that, to such an extent that the brain was 
said to have been exposed. The defence of the prisoner was 
made in part upon the ground that the deceased was intem- 
perate, and was subject to fits, and that he died from the fits 
and not from the blow. But medical witnesses testified that 
such an injury as had been received by the deceased would, 
in most cases, be followed by a fatal termination, and the pri- 
soner was convicted. Here the wound was considered as the 
absolute cause of death. Instances in which some violence is 
the occasion of death are of frequent occurrence. If any severi- 
ty or violence is practiced upon a sick person, so that the 
disease shall be brought to a fatal crisis, the actor must answer 
therefor. If a person acting in the place of a parent in- 
flicts corporeal punishment upon a child, to compel him to 
labor, and the child dies of a disease accelerated by such ill 
treatment, it would be murder if malice could be shown, but 
without this, even if the person believed that the child was 
feigning sickness, and was able to do the work required of 
him, it would still be manslaughter. A case of this kind was 
tried in the courts of Gloucester county a few years ago. A 
person standing in the place of a parent, inflicted numerous 
severe blows upon a child who had been laboring for some 
time under serious disease. From the medical testimony given 
in the case, it appeared that the disease was of such a cha- 
racter that that alone might have been sufficient to produce a 
fatal result ; yet it was conceded that the issue was probably 
hastened by the violence that had been done. The prisoner 
was convicted of manslaughter. This principle holds good 
even in cases where it is considered certain that the disease 
under which the subject was laboring must terminate fatally. 
A husband was indicted for accelerating the death of his wife 
by blows, and it appeared that she was at the time in so bad 
a state of health that she could not possibly have lived more 
than a month or six weeks under any circumstances. But 
the judge instructed the jury that if a person inflicted an in- 
jury upon any one laboring under a mortal disease, which 
injury caused the individual to die sooner than he otherwise 



mulfokd's forensic medicine. 125 

would have done, a charge for manslaughter might be main- 
tained. 

The special design of the actor in these instances, is left out 
of view, the offence taking its character independent of the 
motive. Hence individuals are held accountable, not only 
when death results from open violence, but also when no de- 
sign is apparent to inflict any injury, and even where the appa- 
rent design has been to afford relief. If the course pursued 
was improper, such as was either necessarily dangerous, or 
dangerous from the ignorance, or rashness of the actor, it is 
sufficient. If an individual in offering to aid a woman in labor 
should invert or tear away the uterus, mistaking it for the 
placenta, and death should result, he might be convicted of 
manslaughter. Or, in the treatment of any disease, if articles 
are used which, by persons of knowledge and skill in such 
cases, would be generally regarded as dangerous, either on 
account of quality or quantity, and there is a fatal result, the 
person administering such article may be held accountable. 
Thus, in England a man was found guilty of manslaughter 
who had administered a popular medicine, called Morrison's 
pills to a patient laboring under small-pox. The medicine 
was given in such amount as must, according to the opinion 
of all the medical witnesses, have accelerated death. In the 
words of Lord Lyndhurst, the judge, the man died according 
to all the testimony, by reason of taking the pills. 

The graver forms of homicide open a wide field for medico- 
legal investigation. Here malice aforethought is the import- 
ant ingredient in giving the crime its particular complexion. 
Malice may be either express or implied ; may be gathered 
from declarations of the party, or from acts which manifest 
the intent. The mode in which the offence is committed is 
sometimes alone sufficient to give a manifestation of the tem- 
per of mind. Our law declares that all murder which shall 
be committed by poisoning, lying in wait, &c, shall be deemed 
to be murder in the first degree. 

Perhaps, in no instance is malignity or depravity of heart 



126 mulford's forensic medicine. 

more strongly manifested than in cases of poisoning. In such 
instances, there must always have been a period of delibera- 
tion and thought, as is shown in the selection of articles, and 
in the choice of time, place, and manner. It is also committed 
stealthily, giving the least opportunity to the subject to ward 
off or avoid the danger. Hence, this is justly regarded as 
one of the most detestable, and atrocious of criminal deeds. 

A poison, in the restricted sense attached to the term in 
forensic medicine, is any substance that is capable of destroy- 
ing life in the human subject in a great majority of cases. 
The exhibition of such articles for the purpose of causing 
death, but where the intended effect is not produced, is made 
in our laws a heavy offence. But it is only with poisons when 
causing a fatal issue, that we have now to do. 

The investigation of such cases involves questions of the 
highest importance and interest, and in meeting them, the 
resources of the professional witness will often be closely, and 
severely tested. 

On the present occasion, there is neither time nor need to 
enter upon a full consideration of the several matters connect- 
ed with this offence, but a few remarks of a general nature 
may not be misplaced. 

Investigation in such instances should always be most tho- 
rough and full. Conclusions should scarcely be formed, and 
still less should positive opinions be expressed, upon the basis 
of general symptoms alone. The general symptoms result- 
ing from the operation of poisons, even when perfectly known 
(which in many instances they cannot be), are so far similar 
to those proceeding from other causes, that misapprehension 
may readily occur, and has often occurred. Gastric, and in- 
testinal inflammations of an ordinary kind, though intense in 
degree, has been attributed to poison, and the symptoms pro- 
duced by the latter have been mistaken for those of cholera 
or ileus. General symptoms then are to be considered chiefly 
as pointing the way to further examination. Collateral facts 
and circumstances should be sought after, and a careful in- 
spection of the dead body always be made, including both 



mulford's forensic medicine. 127 

the containing parts, and the contained substances. In snch 
examinations, too, it will be proper that more than one indivi- 
dual should be concerned, especially in cases where it may be 
necessary to resort to processes of nicety for the detection of 
particular articles ; and when practicable, such individuals 
should be summoned or consulted, as will be most likely from 
their situation or other advantages, to possess in the highest 
degree the knowledge and skill that will be required. It is 
no discredit to the profession to declare that many practi- 
tioners, and those too that are highly esteemed, are wanting 
in that precision of knowledge that such cases will frequently 
demand. Even Hunter had reason to regret that he had not 
given the subject of poisons more attention before he ventured 
an opinion in a court of justice. 

Were a due regard paid to these several particulars, were 
the examinations in such cases conducted in a manner to give 
the best possible ground for proper conclusions, and were the 
witnesses careful to have a full comprehension of these grounds, 
and to adhere to them, the painful spectacle of doubting, hesi- 
tating, and disagreeing evidence would not so often be pre- 
sented. 

When homicide is committed in other modes, the difficulty 
will not be so great as when poison has been resorted to. 
The causes that have produced the fatal result will be far 
more obvious. Any external violence will be apparent, and 
the consequences may be determined with comparative readi- 
ness and certainty, yet even here the greatest attention and 
care are to be given ; every appearance denoting injury should 
be examined, and its nature and extent fully determined. 

In some instances, opinions have been given by medical wit- 
nesses from the description of injuries given to them by non- 
medical observers. This is a most uncertain and hazardous 
course. The knowledge of ordinary observers upon such 
subjects can hardly ever be sufficiently exact and full, to en- 
able them to give a perfectly reliable statement ; and no 
more than strongly qualified opinions should ever be given 
founded upon knowledge derived from such sources. 



128 mulford's forensic medicine. 

A very brief notice of some of the particulars embraced 
in the second division of legal medicine may next be taken. 
This division embraces such regulations as are designed for 
the preservation of health and life in communities. The 
health of communities may be influenced by very many cir- 
cumstances, but perhaps it is affected most frequently through 
the medium of food and drinks, and by vitiated states of the 
atmosphere. Hence these are had in view in the sanitary 
regulations adopted by governments. Very commonly, pro- 
visions have been made in reference to articles of general 
consumption, by prohibiting the manufacture and sale of such 
as are supposed to be generally unwholesome. Articles of 
food may be unlit for use, and injurious to health from differ- 
ent causes. The original nutritive material may be bad, as 
when flour has been made from grain that was injured by dis- 
ease, or by admixture with other seeds ; or when the original 
material has been good, it may be adulterated in its prepara- 
tion by the addition of other articles. Various articles are 
used in the preparation of the different kinds of bread, and 
some of these, when used in proper quantity are not usual- 
ly injurious to health ; but the practice of such adultera- 
tions is liable to extreme abuse, and the remark is applicable 
to a great extent, and, perhaps to an equal extent to the 
manufacture of articles of drink. Meats may be rendered 
unwholesome, among other causes, by disease of the animal 
before it was slaughtered, or by unskillful or too long keeping 
afterwards. 

Regulations have been adopted in our State to guard the 
community against the evil effects arising from the sources 
that have just been referred to. A general enactment has 
been made by which it is provided that if any butcher, or 
other person shall sell or expose for sale the flesh of any 
animal dying otherwise than by slaughter, or slaughtered 
whilst diseased, or any contagious or unwholesome flesh ; or if 
any baker, brewer, distiller or other person shall sell unwhole- 
some bread, drinks, or liquor, he or she shall be adjudged 
guilty of a misdemeanor, and on conviction shall be punished 



muleord's forensic medicine. 129 

by fine not exceeding fifty dollars, or by imprisonment in the 
county jail not exceeding four months. 

The application of such an enactment would involve the 
determination of several medico-legal questions. The un~ 
wholesomeness of articles of food or of drink, must be known, 
either by the effects which are actually produced by them, or 
by the detection of such substances as are known to be com- 
monly injurious, or it may be by both of these modes. These 
are matters upon which none but medical men would be able 
properly to decide. 

The health of communities may be iniluenced through the 
medium of the atmosphere, either when the air becomes 
charged with substances that are cognizable by the senses, or 
when it serves as a conveyance to matters which are not per- 
ceptible except from their effects. Many pursuits are liable 
to restraint in densely populated places on this account, as is 
the case with all those trades or manufactures which are 
attended with the formation of impure and offensive gases. 
Among such, may be reckoned brew-houses, glass-houses, 
chandlers' -shops, styes for swine, slaughter-houses, and seve- 
ral others of a similar description. In many of these instances, 
the gaseous substances that are extricated, are exceedingly 
offensive, and often prove a source of actual disease ; and on 
either account, whether as a cause of discomfort or of disorder, 
they may become subjects of legal restrictions. If it can be 
shown that the substances evolved are noxious, and produc- 
tive of notable derangement of the bodily functions, the case 
is the stronger ; but it has been held to be sufficient if it be 
made to appear .that they are so offensive as to prevent the 
proper enjoyment of life. A pure and untainted atmosphere 
is a common right, and no one for his own especial advantage 
may cause it to be vitiated, either as respects the wholesome- 
ness, or pleasantness of its qualities. In our State there is 
no statute directly applicable to cases of this description, but 
proceedings have frequently been instituted at common law or 
under special municipal regulations, and the subject is one 



130 mulford's forensic medicine. 

that is well entitled to notice both from legal and medical 
authorities. 

It is through the medium of the atmosphere that many- 
other causes of disease are believed to come into operation. 
This is the case in epidemical influences, though it may not 
always be easy to determine whether the resulting affections 
are to be attributed to what has been termed the " constitu- 
tion of the atmosphere," or to the diffusion in it, of some spe- 
cial principle, or element. But in some instances the exist- 
ence of such special principle or element is sufficiently mani- 
fested, as is seen in the propagation of infectious and contagious 
diseases. The action of such a cause of disease is unques- 
tioned, though its existence in certain particular cases, as 
well as its nature and origin, have been the subjects of pro- 
tracted discussion. From a very early period, the opinion has 
been held, that most pernicious diseases were contagious, and 
that their spread from place to place, was owing to this pro- 
perty or quality ; and hence the idea that by regulating or 
cutting off the communication with places where such affec- 
tions prevailed, their extension might be checked, or wholly 
prevented. Here is the origin of quarantine regulations. 
In what particular cases such regulations are necessary and 
proper it is not always easy to determine ; sometimes their 
protective effect is decided, whilst at others, they must prove 
ineffectual because the diseases which are to be guarded 
against, may arise in different places, and may have a domes- 
tic origin. Yet even in the latter case, if the spark may be 
kindled at home, yet if it may also be introduced from abroad, 
it is the dictate of wisdom to pay regard to' the more remote 
as well as to the nearer danger. 

Quarantine regulations have not been rigidly maintained 
within the limits of our State, there being but few points 
which are greatly exposed from intercourse with places abroad. 
Yet our vicinity to places of this description within the ad- 
joining States has led to the adoption of provisions which are 
designed to have a concurrent operation. In 1799, a statute 



mulford's forensic medicine. 131 

was passed to secure the citizens of the State against the in- 
troduction of contagious diseases. This prescribes that the 
governor may upon application to him by the authorities of 
Pennsylvania or New York, in regard to any vessel infected 
with malignant disease, and performing quarantine under the 
laws of those States, make proclamation forewarning all per- 
sons from entering on board, or holding communication with 
such vessel, and that if any person shall notwithstanding, 
enter on board, or be concerned in bringing on shore any 
article from such vessel, he shall on conviction be fined any 
sum not exceeding three hundred dollars. 

Another statute was passed in 1812, similar in its objects 
to that just mentioned. This, however, was designed to be 
local in its operation, applying only to the city of Perth Am- 
boy. The regulation seems also to have been directed espe- 
cially against one particular form of pestilence, the yellow 
fever of the south. The act prescribes that all vessels arriv- 
ing at the port of Perth Amboy between the 31st of May 
and the 1st of October, from any port, island, or other place 
lying in America south of Georgia ; or from any West India 
Island, or other place where yellow or pestilential fever pre- 
vails, or on board of which vessel any person shall have died 
while at a foreign port, or on the passage home, shall remain 
at anchor at a certain distance prescribed, and be subject to 
the examination of the health officer, and to such regulations 
as he may direct. 

Though not strictly, it may be within the limits of legal 
medicine as usually defined, but yet as a portion of the legis- 
lation of our State designed for the preservation of the health 
and the lives of its citizens, there is another enactment which 
should not pass without some notice. It is the act incor- 
porating the Medical Society of our State, and, perhaps, 
there is no single enactment of greater importance. This 
act was designed primarily to give such encouragement and 
protection as the authority of law may properly give to those 
who have devoted themselves in a proper manner to the most 
noble, but the most difficult of human pursuits. It aims to 



132 mulfokd's forensic medicine. 

sustain the elevated standard of character which this pursuit 
so eminently requires ; it favors him who has sought with 
earnestness and honesty, to fit himself for the place he has 
assumed, and worthily to perform the duties it involves, 
whilst it gives no countenance to ignorance and pretence. 
It gives security to him who seeks the high places and the 
high rewards of our profession, in a proper spirit, and in the 
appointed ways,. but warns away such as attempt to reach 
them by audacity or fraud. Like most of the legislation of 
our State, this enactment has been conceived in a spirit of en- 
lightened justice. It seeks not to establish a mere equality 
of honors and advantages, giving alike to the workers and to 
the drone ; instead of this, it would place the reward in the 
hand of him by whom it has been fairly and honorably won. 
The effect of legislation of this kind may be easily perceived, 
not only upon those who are its immediate objects, but also 
upon the welfare of the community at large. In so far as 
the grade of professional attainment is raised, there will be 
given, in a proportionate degree, an increased capability for 
the discharge of professional duty : the law gives advantages 
to those who have complied with its requisitions, but this 
grant is not made for the purpose of establishing distinctions, 
any further than as these may serve as a guaranty for the 
better performance of obligations. The distinction is some- 
thing — it is much, it should be, and it will be sought and 
valued by all those who properly regard and appreciate their 
calling ; but in the eye of the law, this is not the principal 
object in view, in this respect, regard is had to the evidence 
which a man has given that he is worthy of trust when he 
goes forth into society to deal with health and life. 

Most earnestly is it to be hoped that the wise and benevo- 
lent purposes of the legislative authorities of our State may 
be fully attained. Toward this end, let each and every mem- 
ber of this society act up in the fullest manner to the spirit 
of our laws, and to the spirit of our high profession. 

Camden, N. J"., 12th mo. 1850. 



PAUL ON THE SECRETING FUNCTION OF THE COLON. 133 



To the Editor of the Reporter, 

Sir: — According to your request, I send you my paper on the secreting 
function of the large intestines. I can lay little claim to originality in this 
paper, mainly made up as it is of extracts from authors, so necessary to elucidate 
my subject. It is for you, therefore, to judge of its fitness for the pages of the 
Reporter, to the exclusion of matter of more interest ; although not, perhaps, of 
more practical importance. 

I am, sir, yours truly, 

JAS. PAUL. 
Trentost, November 28, 1850. 

ON THE SECRETING FUNCTION OF THE COLON. 

BY JAS. PAUL, M. D. 
[Read before the District Medical Society for the County of Mercer.] 

Although great and deserved attention is paid to the 
secretions in disease, both urinary and faecal, and in a great 
many of the diseases to which the human frame is liable, par- 
ticularly in fevers, there is no surer criterion to lead us in 
our prognostications, or guide us in our remedial efforts than 
the appearance of the excretions. I do not know if we are 
so thoroughly acquainted with the philosophy of the faecal 
discharges as we ought to be, or that we view them altogether 
in the physiological bearing to which they properly belong in 
the animal economy. 

We are, I think, too much in the habit of viewing the ex- 
crements merely as an index of the food having undergone 
the proper and necessary process of digestion, and when we 
see pieces of undigested aliment mixed up in the faeces, we 
naturally conclude and say that the substances consumed, 
whether of potato, apple, carrot, or whatever else has been 
partaken of, has not been digested. 

Even this, however, is not without its use — for although in 
such cases the pressing symptoms, whether of croupy cough, 
nervous twitches, or convulsive spasms, are relieved by evacu- 
ating the alimentary canal of foreign and irritating substances, 
it yet enables us to note what portion of the digestive func- 



134 PAUL ON THE SECRETING FUNCTION OF THE COLON. 

tion is incomplete, whether the deficiency lies in the non-ren- 
dering the vegetable food into the saccharine principle, or 
otherwise, and so to alter the food to that which can be di- 
gested, and direct our remedial efforts to that portion of the 
function which is deficient. 

My purpose at this time, however, is not with the function 
of digestion, but to direct our attention to the faecal secre- 
tions or excretions, and to the colon, or large intestine as a 
great secreting organ. 

Every practitioner is more or less acquainted with the ap- 
pearance of the secretions as they are passed from the body 
of a patient laboring under fever — the brownish watery dis- 
charges having a cadaverous or fleshy smell, the black or 
dark green discharges resembling blubber, or the green fat of 
turtle, having a highly offensive and putrid odor — and the 
gradual return to the yellowish watery discharges having as 
convalescence is established, more consistence, and the more 
genial odor of proper faeces. I do not intend to enter into, 
neither is it needful that I should, the various appearances of 
the faecal discharges in disease, nor the altered appearances 
caused by various remedial agents. 

It has been a question among physiologists of the older 
school, whether absorption takes place in the larger intes- 
tines ? On this subject, Blumenbach has the following — u It 
has been inquired whether lacteals exist also in the large 
intestines, and their existence has been contended for from 
the effects of particular injections, nutrients, inebriating, &c, 
and also by the circumstance that the faeces if retained for 
any length of time become hard and dry. Although these 
arguments do not demonstrate the absorption of genuine chyle 
below the valve of Fallopius, nevertheless, it is rendered pro- 
bable by the visible existence of an abundance of lymphatics 
in the large intestines having the same structure and function 
with the lacteals, for these absorb lymph from the intestines 
during the absence of chyle. 

" But the very different structure of the internal coat of 
the large intestines from that of the villous coat of the small, 



PAUL ON THE SECKETING FUNCTION OF THE COLON. 135 

strongly argues that they are not naturally intended to ab- 
sorb chyle." — Blumenbach, 233. 

Our present views of the transudation of liquids through 
animal texture, will readily enable us to comprehend how ab- 
sorption may take place, and nourishment be conveyed into 
the system when thrown into the large intestines, and even 
only into the rectum by means of injections. Nor is it at all 
incompatible with physiological facts that absorption and se- 
cretion should go on in the same organ, and through the same 
texture by different sets of vessels. 

The same unsatisfactory knowledge, if I may be allowed 
the expression, exists regarding the functions and uses of 
the mesenteric glands of the colon. Prof. Grant, treating of 
these organs, says : " There are nearly a hundred of these 
organs on the human lacteals, and about a fourth part of these 
belong to the colon ; but the changes they effect on the fluids 
which are incessantly passing through them during life, and 
even for some time after death, or the uses to which they are 
subservient in the economy, are still unknown, like the functions 
of many other obvious parts of our most complicated and 
wonderful fabric." — Prof. G-r ant's Lectures, Jan. 26, 1824. 

Following up the argument of the absorption of chyle, and 
its having been seen in the mesenteric veins, Blumenbach says : 
" The assertion that chyle has been seen in the mesenteric 
veins requires further investigation and proof ; so that I can- 
not believe that they carry anything more than blood, being 
carbonized and destined for the formation of bile." — Blumen- 
bach, 234. 

Here, then, we find the blood loaded and surcharged with 
that principle, of which a great portion of the faeces is com- 
posed. 

Having thus briefly alluded to the views generally and for- 
merly entertained by physiologists, let us enter more minutely 
into the structure of that portion of the large intestines in 
which this most important function is situate. " A part of 
the faeces, however (says Carpenter), may be derived from the 
secretions of the enteritic mucous membrane, and of its glan- 



136 PAUL ON THE SECRETING FUNCTION OF THE COLON, 

dulse ; the surface of the former, with its simple follicles, 
probably secretes nothing but mucus ; but the glandulse with 
which it is so thickly studded appear to serve as the channel 
for the elimination of putrescent matter from the blood. 
There can be no doubt that a large quantity of fluid is poured 
out by these glandulse when they are in a state of irritation 
from disease, or from the stimulus of a purgative medicine ; 
since the amount of water discharged from the bowels is often 
much greater than that which has been ingested, and must 
be derived from the blood." — Carpenter, 501. 

For a description of these glandulse, allow me to transcribe 
from the same author the following: " The whole mucous 
surface of the intestinal canal is furnished with glandular 
follicles of a very similar character ; of which some approach 
those of the stomach in complexity of structure, whilst others 
evidently correspond with the crypts of ordinary mucous 
membrane. An innumerable multitude of pores are easily 
seen by the aid of a simple lens to cover the whole internal 
surface of the large intestines, and these are the entrances 
to tubular follicles closely resembling those of the stomach, 
but more simple in structure. Their ccecal extremities shut 
against the submucous tissue ; towards the end of the rectum, 
however, they are much prolonged, and constitute a peculiar 
layer between the mucous and muscular coats ; the tubes 
which are there visible to the naked eye being erect, parallel, 
and densely crowded. These glands probably form the pecu- 
liarly thick and tenacious mucus of the large intestine." — 
Carpenter, 668. 

And of the functions of this glandular structure, the same 
author observes, "Although the particular use of each variety 
of the intestinal glandule cannot yet be determined, there 
seems little doubt that their general function is to eliminate 
from the blood those putrescent matters which would other- 
wise accumulate in it ; whether as one of the results of the 
normal waste of the system, or as produced by various mor- 
bific causes which act as ferments, and thus occasion an un- 
usual tendency to decomposition in the solids and fluids of the 



PAUL ON THE SECRETING FUNCTION OF THE COLON. 137 

body. That the putrescent elements of the faeces are not 
derived from the food taken in, so much as from the excret- 
ing action of the intestinal glandulee, appears from this con- 
sideration among others ; that fsecal matter is still discharged, 
even in considerable quantities, long after the intestinal tube 
has been completely emptied of its alimentary contents. We 
see this in the course of many diseases where food is not 
taken for many days, during which time the bowels have been 
completely emptied of their previous contents by repeated 
evacuations, and whatever then passes in addition to the 
biliary and* pancreatic fluids must be derived from the intes- 
tinal walls themselves. Sometimes a copious flux of putrescent 
matter continues to take place spontaneously, whilst it is often 
produced by the agency of purgative medicine. The ' Colli- 
quative Diarrhoea' which frequently comes on at the close of 
exhausting diseases, and which usually precedes death by 
starvation, appears to depend not so much upon a disordered 
state of the intestinal glandulse themselves, as upon the gene- 
ral disintegration of the solids of the body, which calls them 
into extraordinary activity for the purpose of separating the 
decomposing matter." — Carpenter, 670. 

What I have just read is so comprehensive, and brings the 
subject so forcibly and powerfully to the mind as to preclude 
the necessity almost of entering more fully upon it. 

My attention was particularly drawn to this subject by the 
frequent occurrence of immense quantities of the morbific 
and putrid discharges by stool, in tropical fevers, immediately 
before returning convalescence. At the commencement of 
the disease, the alimentary canal would be carefully emptied 
by repeated doses of purgative medicine, the fever would con- 
tinue, watery stools would supervene ; at this period the patient 
would take the simplest nourishment, and that in small quan- 
tities, and in many cases none at all, the stomach rejecting 
every particle of food exhibited — in the progress of the dis- 
ease, the patient prostrated and nearly fainting on the least 
exertion, large dejections would occur of dark-colored gela- 
tinous offensive matter — quarts, and I may say gallons on 



138 PAUL ON THE SECRETING FUNCTION OF THE COLON. 

some occasions, are passed off at repeated operations — and 
although the patient at this time would be scarcely able to 
move or speak, yet after such evacuations he would feel more 
easy — a moisture appear on the surface — the critical moment 
being seized, and nourishment with wine or brandy exhibited 
— the patient slumbers, and from that time convalescence pro- 
gresses. 

And what is the result if this dark offensive matter is not 
thrown off ? It is more than probable that the fever will 
continue, and in more favored climates a slow and dilatory 
convalescence may ensue, or the whole system becomes cor- 
rupted, and in a tropical climate putrefaction succeeds almost 
ere the being has ceased to breathe. 

In the epidemic which has so lately made such havoc and 
run its course in some cities of the Union, causing such fear- 
ful mortality, the non-performance of the proper functions of 
the secreting glands of the intestines is no doubt a principal 
effect. Without entering: into the manner in which the mor- 
bific poison of the cholera acts on the system, we see an 
abeyance of the proper secretions — of bile, urine, and faecal 
discharges, and in their stead a watery secretion is ejected, 
even with force, from the stomach and intestines, without 
straining, and without pain ; indeed, so offensive is the pre- 
sence of this secreted fluid to the stomach and intestinal canal, 
that the patient can scarcely control its ejectment for a few 
seconds. And this unusual parting with the serous portion 
of the blood leaves the remaining portion thick, viscial, and 
incapable of entering the minute or capillary vessels, and col- 
lapse is the consequence — but arrest the serous discharges, 
and once produce a faecal evacuation with tinges of biliary 
secretion, and there is every chance of the recovery of the 
patient. Hence, it is obvious that the secreting organ of the 
large intestines is seriously affected in this formidable disease. 
I call it formidable from the fatality attending the visitation, 
but in my opinion controllable in a great majority of cases 
where the patient has been timely put under the care of the 



PAUL ON THE SECRETING FUNCTION OF THE COLON. 139 

physician, and remedial and energetic measures have been 
pursued. 

Every practitioner will no doubt bring to his recollection 
cases in which the patient, even after repeated and free eva- 
cuations, will answer to the inquiry regarding his feelings, 
" I am better — my medicine has acted very well — still I feel 
as if there was yet something to come away.'' Is it not pro- 
bable that this feeling, indescribable to the patient, not amount- 
ing to pain, and relieved by a copious evacuation has been 
owing to the surcharged state of the mesenteric veins, and the 
relief the consequence of the active secretion from the glan- 
diilee which has been the subject of consideration. 

The secretion of the liver is looked for, and the returning 
appearance of bile in the faecal discharges is held in great 
estimation, and properly so, by most, if not by all prac- 
tical physicians ; its proper action is absolutely necessary to 
recovery from disease and the enjoyment of health. It is not 
my object to withdraw attention from that most important 
organ, but to direct more particular attention to the colon as 
a great secreting organ ; that the faeces, which in health may 
contain that portion of the food which has not been absorbed 
into the system, more especially when a superabundant quan- 
tity of aliment has been consumed, is for the most part secret- 
ed by the large intestines, from which the deleterious and 
disintegrated portions of the organic mass is passed away, 
and the system freed of much of the superabundant carbon 
which may not be required for the purposes of respiration. 



vol. iv. — 14 



BIBLIOGRAPHICAL NOTICES. 



'An Inaugural Essay on Zoo-Adynamia, presented for the de- 
gree of Doctor of Medicine in the University of Pennsyl- 
vania. By Geo. J. Ziegler, M. D. Published upon the 
recommendation of Professor Jackson. Philadelphia : Lip- 
pincott, Grambo & Co., 1850. 

This is the title of a pamphlet of sixty-four pages, for a 
copy of which, we are indebted to the author. The term Zoo- 
Adynamia is intended to signify that condition of the system 
in which there is a privation, or deficiency of animal, or living 
power ; and in treating of the subject, the author has divided 
it into physico-adynamia, meaning a deficiency or privation 
of mental power ; and neuro-adynamia, signifying a deficiency 
of nerve power ; which is subdivided into general and special 
sensory-adynamia, and voluntary and involuntary motor-ady- 
namia. 

Under these several divisions a great variety of diseases 
are considered, with certain novel suggestions with reference 
to their treatment, which are well worthy the attention of the 
profession. Our space will not admit of even a notice of all 
the " lesions of function, and nutrition," &c, which are enu- 
merated, but we shall content ourselves with a few extracts 
on the use of nitrous oxide gas as a remedial agent. 

" This gas appears to have been strangely overlooked and 
neglected by the profession as a remedial agent. It is well 
known that it is a powerful, rapid, and permanent arterial 
and nervous stimulant, exciting an ecstatic feeling, as if we 
were elevated many degrees above this life to a higher and 
more refined degree of organization or existence, divested of 
all the gross accompaniments of this, and this feeling not 
being followed by that state of sedation or depression which 
results from oxygen and other stimulants, having properties 
much more analogous, and therefore more appropriate, to the 



BIBLIOGRAPHICAL NOTICES. 141 

atmospheric air than any other compound of nitrogen and 
oxygen, or even pure oxygen, or any other known substance. 

5jC JjC ?|C 5JC ^C ^j? 5fC ?JC >jC >fC 5|C 

" In cholera Asiatica, the poison seems to act primarily on 
the nervous system to depress it, and at the same time to 
arrest the chemical action going on in the blood, both by its 
impression upon the nervous system, and also most probably 
by its destroying the affinities between the components of the 
blood by catalysis, or by its greater affinity for different parts 
of the blood ; thus probably forming a compound of the poison 
and serum, or liquor sanguinis, which would be the whitish or 
rice-water discharges from the stomach and bowels : this fluid 
or compound having a great affinity for the membranes of the 
alimentary canal, or from the great vascularity of the abdo- 
minal viscera, the fluids having a greater tendency to that 
part, and when exosmosed through into the canal, by its pre- 
sence causing an action of emesis or purgation to get rid of it. 

" In our treatment of this disease, however, without regard 
to our views of its pathology, we must endeavor to prevent 
or correct this nervous depression, and also the separation of 
the blood ; and as in other diseases we resort to the setting- 
up of another action to get rid of the disease, we on the same 
grounds would resort to an analogous mode in this disease ; 
therefore, the nitrous oxide, by its nervous and arterial stimu- 
lation through its chemical and vital action, would, I believe, 
subvert both the tendency to a separation of the components 
of the blood and the nervous depression, and consequently 
prevent or arrest the progress of the disease after it has com- 
menced ; that is, before the stage of collapse, provided that 
collapse is dependent in some measure on the excessive drain ; 
if there has not been any drain, or to a small extent, from 
the circulation, and the temperature has not been reduced too 
low for chemical action, even in collapse the nitrous oxide 
would probably assist materially in reviving the depressed vital 
forces, and thus preserve the life of the patient. 

"In the exhibition of nitrous oxide, however, it should not 
be used ad libitum or indiscriminately, as it is capable of doing 
much harm, and particularly where the movements of the 
living machinery are impeded, or become sluggish, upon mere 
mechanical principles. Thus, if a body is at rest, or in slow 
motion, and it is attempted to set that body in rapid motion 
suddenly, there will in all probability be a rupture or separa- 
tion of the particles; hence, in the prostrated condition of 
the system in cholera or any other similar condition, by ex- 
citing a sudden or rapid action of the heart and nervous sys- 



142 BIBLIOGRAPHICAL NOTICES. 

tern, death may ensue from actual rupture or solution of con- 
tinuity of the heart itself, the vessels leading from it, or the 
parts to which the blood is sent, as the brain, &c. ; and also, 
by exciting vital action too rapidly, all of the free force of 
vital power may be exhausted before the latent (if the ex- 
pression may be allowed) is developed and eliminated, and 
thus again produce a fatal result. Therefore, in using this 
agent — and the principle is applicable to other stimulants in 
a similar condition of system, from whatever cause produced 
— it should be given in small quantities, and at first very gra- 
dually; on the principle of slowly introducing steam into the 
cylinder and gradually increasing it to move the piston and 
drive the machine. 

" In this way, in a short time, a considerable quantity of 
nitrous oxide might be introduced into the system, exciting 
active and permanent chemical and vital action, and thus 
overpowering or subverting the action of the poison, and 
supporting arterial and nervous power until the poison has 
been eliminated or its influence exhausted, analogous to the 
treatment in other poisons, such as typhus, opium, &c. Dur- 
ing our attempts, or after we have thus arrested the abnormal 
action, small closes of calomel and opium, with acetate of lead 
as recommended by Professor Wood, with the addition of 
strychnia, being one of the most powerful nervous stimulants 
known, by acting on, exciting and increasing the secretion 
from the liver and other organs, contracting intestinal and 
other tissues, and stimulating and supporting still further the 
nervous system, would no doubt prove highly useful. Also, 
at the same time, in addition, ' electrical insulation,' as recom- 
mended by Mr. Pallas, might be employed with probably great 
advantage." 

In those cases of adynamia resulting from non-arterializa- 
tion of the blood, in which the mere exposure to pure fresh 
air is not sufficient to eliminate from the system the excess of 
carbonic acid, it is recommended to introduce an additional 
quantity of oxygen by inhalations of the nitrous oxide gas, 
and thus sustain life action, till the overcharged pulmonary 
tissue may be relieved by the more rapid elimination of the 
poison. The nitrous oxide being analogous in constitution to 
atmospheric air, but possessing a more stimulating power, is 
also supposed to be a useful agent in cases of asphyxia pro- 
duced by carbonic acid, in drowning, cyanosis, and in all 



BIBLIOGRAPHICAL NOTICES. 143 

cases of debility or adynamia, dependent upon deficiency of 
oxygen in the blood. 

" In the adynamic fevers from poisonous exhalation, either 
of vegetable or animal origin, one of the most important in- 
dications is to support the strength until the poison has ex- 
hausted itself or been eliminated from the system, or the 
cessation of its influence upon the economy, except in cases 
where the attack is comparatively mild, as it is very frequently 
in intermittent, remittent, &c. ; the supporting and curative 
means being the same, and acting at the same time, the 
paroxysms being prevented or arrested in a short time by 
nervous stimulants, tonics, antiperiodics, &c, as cinchona, 
quinia, strychnia, opium, &c. In the early stages of inter- 
mittent, before the system has become much reduced, nitrous 
oxide, by its action on the blood and nervous system, would 
most probably arrest or entirely prevent the paroxysm. In 
intermittent, Mr. Pallas speaks very highly of ' electrical in- 
sulation.' He says that 'cases of intermittent fever — whe- 
ther quotidian, tertian or irregular, if not complicated with 
bronchial irritation — yielded to the sole influence of insula- 
tion, without the necessity of having recourse to quinine or 
any other medicine.' In this disease, it is well known that 
powerful mental impressions, or a consciousness on the part 
of the patient that he will not have another paroxysm will 
frequently prevent it ; therefore, further experiments will be 
necessary before it is received as an established fact, although 
not wishing in the least to impugn the veracity of Mr. Pal- 
las's experiments and statements, the attempt to, or the addi- 
tion of any new facts to the mass of human knowledge being 
highly commendable ; and if it is useful in this disease, it 
will, in all probability, be also in all adynamic conditions, 
particularly the adynamic fevers. 

" In typhus, yellow, and congestive fevers, and all similar 
conditions, the disease runs its course sometimes very ra- 
pidly, and, if not arrested, will speedily prove fatal. In all 
of these diseases there appears to be a tendency to a lesion 
of the blood, which would account, in some measure, for their 
intractability to treatment and fatality. Considering that in 
all such diseases, including cholera, hydrophobia, &c, death 
is not always the consequence directly of the nervous pros- 
tration, but from the permanent change in the blood, from 
the arrestation or perversion of chemical or other actions in it 
necessary for its perfection, and the consequent prevention or 
suspension of the process for the formation of plasma, &c, 



144 BIBLIOGRAPHICAL NOTICES. 

and the production and conveyance of nutriment and stimuli 
to the nervous system." 

We might refer to many more points of interest in this 
pamphlet; some excellent remarks on the subject of "sym- 
pathy," "inanition," &c, are worthy of notice, but we have 
already devoted more space than was originally allotted to 
this subject, and must, therefore, dismiss it. 



" Contributions to the History, Diagnosis, and Treatment of 

Croup, 

Is the title of a series of excellent papers read before the 
Boston Society for Medical Improvement, by John Ware, 
M. D., of that city, and recently published in the Boston 
Medical and Surgical Journal, one of our most valued ex- 
changes. As the article is long, we can do no more than 
give our readers a general review of it, in doing which we 
shall quote so freely that quotation marks would be superfluous. 
Dr. Ware's observations are based upon 131 cases that 
occurred in his own practice, extending through a period of 
twelve years from January, 1830, to July, 1842. 

He begins by declaring his belief that an original and 
essential difference exists between the two varieties of croup, 
the one being pathologically different from the other; yet, he 
is not prepared to assert positively with our present amount 
of knowledge, that the different varieties are not different 
manifestations of the same disease. 

For convenience of reference he divides his cases into four 
classes. Of the whole number there were, 

Cases. Deaths. 

Of membranous croup, 22 19 

Inflammatory " 18 

Spasmodic " 35 

Catarrhal " 56 

131 19 



BIBLIOGRAPHICAL NOTICES. 145 

In the first class are included those cases in which there is 
reason to believe that a false membrane has been actually 
formed, lining the larynx and trachea. 

In the second class, those cases in which the symptoms are 
for the most part, of the same character as in the first, but 
in which there is reason to believe that no membrane has been 
formed. The grounds of the opinion formed of the nature 
of these two classes will be stated subsequently. 

The cough, the voice, and the respiration, are the symp- 
toms on which dependence is placed in the diagnosis of 
this disease. During the earlier stage of the first form when 
diagnosis would be the most valuable, there is little in the 
cough or the voice on which we can found a proper diagnosis. 

But much more may be learned from the condition of the 
respiration, which too often escapes the notice of the physi- 
cian. The common description of the breathing in croup 
does not apply well to the beginning of the membranous 
variety. It seems rather taken from cases of a less danger- 
ous kind, in which the breathing is from the first, loud, harsh, 
suffocative ; attended with great efforts, and much loud cough- 
ing; creating great alarm, and calling at once for efficient 
means of relief. But the breathing in membranous croup 
does not excite attention in the very commencement of the 
disease. It is comparatively quiet and unobtrusive. Its true 
character is not at once to be detected, but only by a careful 
and accurate observation. The patient has not the ordinary 
aspect of difficult breathing ; in fact the breathing is not dif- 
ficult at the very first. He probably experiences no distress. 
There is no real deficiency in the performance of the function, 
and no obvious embarrassment ; there is only a little more 
effort in drawing in the air, and a little more force exercised 
in its expulsion, whilst the amount of air admitted and ex- 
pelled is fully equal to the necessities of life. This, perhaps, 
would not be noticed on a casual glance at the patient, but 
will be at once perceived on attending to the muscular move- 
ments subservient to the function, which are, to use an ex- 
pressive French term, somewhat exalted. It is indicated very 



146 BIBLIOGRAPHICAL NOTICES. 

soon also, by a slight dilatation of the nostrils, and a little 
whiz or buzz accompanying the passage of air through the 
rima glottidis; this sound is distinguished either by placing 
the ear near the mouth of the patient, or by applying the 
stethoscope on the back of the neck, or directly upon the 
upper part of the larynx. This condition of the respiration 
is not, however, always found as pure as has been described ; 
it is often mingled with and obscured by other sounds. Thus 
the disease is often attended by paroxysms of irregular and 
spasmodic breathing, accompanied by violent muscular efforts 
and great distress, and of course producing other and more 
obvious sounds than those described. There is often, also, 
present in the air-passages, either above or below the glottis, 
a quantity of mucus giving rise to a constant or occasional 
rattling, which seems to mask the proper sound of croup. 
These adventitious sounds being also as frequently heard in 
the other forms of croup, are, therefore, of no service in diag- 
nosis. Generally there are intervals of relief from these su- 
peradded symptoms, especially immediately after vomiting or 
bleeding, but the essential breathing of the disease will be 
found to be unchanged and unmitigated in these intervals of 
ease ; although the apparent relief may be so considerable as 
to give rise to strong but fallacious hopes of recovery. 

A kind of breathing sometimes heard in cases of enlarged 
tonsils may be readily distinguished from that of croup by 
attending carefully to the seat of the obstruction, which is 
above the rima glottidis in the one case, and at it in the other, 
by the sound of the cough and voice, which are not croupy, 
and by the fact that the obstruction varies in degree, and 
sometimes vanishes, with a change of position. 

The condition of the respiration above described, depend- 
ing as it does on mechanical obstruction becomes more obvious 
as the disease advances. In the advanced stage of croup 
the breathing is often modified by other circumstances than 
the mere mechanical obstruction at the upper part of the 
larynx. The false membrane which becomes partially de- 
tached by the secretion of pus may modify it, and sometimes 
even cause sudden death by collecting into a mass and caus- 



BIBLIOGRAPHICAL NOTICES. 147 

ing suffocation. Other causes modifying the breathing are men- 
tioned, such as congestion, or inflammation of the lungs, and 
an accumulation of air in them, arising from a want of balance 
between inspiration and expiration. This peculiarity of re- 
spiration characterizing the first form of croup, Dr. Ware de- 
signates as intense. 

The condition of the respiration, cough, and voice in the 
second form is very similar to that in the first. The diagno- 
sis between these two forms, and the reasons for separating 
them will be treated of soon. In a few cases of this form of 
the disease, Dr. W. has noticed a tenderness of the larynx on 
pressure. 

His third class includes certain cases which are generally 
designated as spasmodic croup, and sometimes as spasmodic 
asthma. In this form the attack is always sudden and vio- 
lent, causing great alarm, and calls for immediate assistance. 
It is apt to produce a greater sensation on the minds of com- 
mon observers than the other form ; the inspiration is very 
difficult, whilst the expiration is comparatively quiet and easy. 
The attacks usually come on early in the evening, soon after 
the patient has retired to bed, but, perhaps as frequently, at 
a later hour of the night, or very early in the morning. 
These cases seem occasionally to arise from indigestion, but 
more frequently we can trace their occurrence to cold, being 
often preceded for a few days by symptoms of catarrh, but at 
no period is there any proper intensity of respiration. 

These cases rarely fail to yield to an emetic or venesection, 
leaving behind them for a longer or shorter period, some 
hoarseness, and croupy sound of the cough, with a little husk- 
iness or stuffiness of the breathing. 

The fourth class includes cases which frequently present a 
very close resemblance to the others, without, however, the 
intense exalted action of the respiratory muscles, and no in- 
dication of that mechanical impediment to the current of air 
which exists at the rima glottidis in the two first forms of the 
disease. It usually follows symptoms of common catarrh. 
These cases, from the manner in which they come and go off. 



148 BIBLIOGRAPHICAL NOTICES. 

Dr. W. supposes to be properly a catarrhal inflammation of 
the mucous membrane covering the organs of voice. He ob- 
serves that the catarrhal affection of the same membrane 
which occurs in the first stage of measles is accompanied by 
the same croupy symptoms as those which have been now de- 
scribed, and pass off with the other catarrhal symptoms. The 
attacks in this form of croup have in a few instances termi- 
nated in severe bronchitis, or in inflammation of the lungs 
themselves. 

Having thus described the different varieties, Dr. Ware 
next proceeds to discuss the questio vexata, viz : Are these 
different forms of croup pathologically different, or are they 
only different manifestations of one and the same disease ? 
Of course, if they are pathologically different, it is of im- 
portance as regards both prognosis and treatment to be 
able to recognize the true nature of the disease early. For, 
if we can with regard to a large proportion of the cases con- 
fidently predict from the outset a favorable issue, the prac- 
titioner and friends will be saved much unnecessary anxiety, 
and the patient many annoying and debilitating remedies. 
The attention will now be particularly directed to the pecu- 
liarities distinguishing the first and second forms, as the dis- 
tinction between the other forms is not of the same practical 
importance. Dr. W. begins this part of his subject by notic- 
ing the peculiar fatality attending those cases of croup in 
which a layer of coagulable lymph or false membrane — known 
familiarly, though inaccurately, under the name of " ulcerated 
sore throat"— is thrown out in the fauces, or on the tonsils, 
and considers it of great consequence to examine the fauces 
not only in cases of well-defined croup, but in catarrhs, espe- 
cially if there are present any croupy symptoms. The appear- 
ance of a false membrane on the tonsils or other visible part 
of the throat in a case of croup, he considers, may be regarded 
as a pretty certain diagnostic sign that it is the membranous 
form of the disease ; and its absence a pretty certain indica- 
tion that it is one of the other forms. In seventy-five cases 
in which this false membrane was looked for, and the result 
noticed, it failed as a diagnostic sign in but a single instance. 



BIBLIOGRAPHICAL NOTICES. 149 

The grounds for believing that the two forms of disease 
which he has distinguished as membranous and inflammatory 
are pathologically different, are : — 

1. The very great preponderance of fatal results in the 
membranous croup, and a similar preponderance of recoveries 
in the inflammatory ; and the evidence which exists that in 
the few cases of recovery from the former, the membrane has 
been formed, and in the few cases on record of death from 
the latter, that a membrane has not been formed, afford 
strong reasons for believing that the diseases are essentially 
different. 

2. The formation of a false membrane does not seem to re- 
quire either an advanced stage, or a very intense degree of 
the inflammation from which it proceeds. It is rather the 
result of a peculiarity in the kind of inflammation than of 
any period or degree of it. It appears to be a very early 
product of the inflammation, if it be not, indeed, almost co- 
temporaneous with it. It resembles in this respect the similar 
effusion taking place on the serous membranes, which in them 
occurs very early, and has even been supposed to be the first 
act of inflammation. 

3. Difference in the manner of recovery of the two forms ; 
in the inflammatory form it being rapid and speedily com- 
plete, and in the membranous form slow, and accompanied by 
phenomena which must necessarily attend the separation of 
the membrane, &c. This is thrown off by the occurrence of 
suppurative inflammation, and usually begins in the trachea. 
It is obvious that recovery might always take place could the 
parts be spared long enough from their functions to go through 
the necessary steps ; and it is also obvious when it does take 
place, that it must be accompanied by a copious expectora- 
tion of pus, and of the membrane either in pieces, if firm 
enough, or else broken up and partially dissolved by the pus. 
Now these appearances do not accompany recovery from even 
the severest cases of the inflammatory croup, whilst they do 
accompany well-marked cases of the membranous form. 

His observations seem to justify the following conclusions : 
1. That the only form of croup attended with any consider- 



150 BIBLIOGRAPHICAL NOTICES. 

able danger to life is that which is distinguished by the pre- 
sence of a false membrane in the air-passages. 

2. That the existence of this membrane in the air-pas- 
sages is, in a very large proportion of instances, indicated by 
the existence of a similar membrane in the visible parts of 
the throat. 

3. That this affection differs not in stage or degree, but in 
kind, from all the other cases which are commonly known 
by the same name, and that the latter have no tendency to 
be converted into or to terminate in the former. 

It is usually only the milder forms of croup which attack 
suddenly and violently ; such an attack is, therefore, to be re- 
garded as affording a favorable indication of the character of 
the case in which it occurs. 

Genuine or membranous croup is usually rather gradual in 
its approach, often supervening on the common sore throat of 
children. It also sometimes occurs as a sequel to the affec- 
tion of the throat in scarlatina when it is usually very rapid, 
and inevitably fatal. 

Of twenty-three cases of membranous croup, nineteen, or 
more than three-fourths were of four days' duration or less. 

The membranous form of croup rarely attacks children 
under two years of age. Of thirty-three cases of which the 
ages were known, only two were under two years of age, 
and twenty-two, or two-thirds of the cases were between two 
and five. The tendency to the other forms prevails at a much 
earlier age. 

Treatment. — Dr. W. begins by saying, that in his opinion, 
the depleting, reducing, and perturbating methods of treat- 
ment which have come down to us by a sort of tradition, and 
have been adhered to by most practitioners, require a careful 
reconsideration. This method of treatment may be applicable 
to a considerable proportion of cases usually denominated 
croup, viz : those which he has classed above as inflammatory, 
spasmodic, and catarrhal. But so far as his experience goes, 
they make no impression on the membranous form. He thinks 
the different stages into which croup is commonly divided are 
made up from different sets of cases, going to one for the his- 



BIBLIOGRAPHICAL NOTICES. 151 

tory of one case, and to another for the history of the second. 
This confusion of diagnosis, which he compares to classing 
all cases of cough with expectoration as consumption, as "con- 
sumption doctors" do, has given an apparent success to the 
means used for treatment. 

The question now arises, if the mode of treating mem- 
branous croup commonly adopted does no good, are we sure 
it does no hurt ? We find that there is a tendency in the 
disease to go through a certain course of changes which 
will terminate in health. For, after a time a process of 
suppuration is established between the thickened and con- 
gested mucous membrane and the false membrane, thus sepa- 
rating the latter, which is coughed up in patches, shreds, &c, 
or converted into pus and expectorated. This process goes 
on gradually, and when croup is once established, it can only 
be recovered from by going through with this regular course 
of changes. 

A rational method of treatment then, is that which will 
promote the necessary changes. For this we need, 1. To 
prolong life, to prevent suffocation, in order to give time for 
the required process to be completed by the efforts of the 
organs themselves ; and, 2. To use means which will promote 
and hasten this process, which will aid the system in the 
work which she is aiming to perform. Dr. W. doubts the 
efficiency of the usual mode of treatment in fulfilling these 
indications, and thinks, that in so formidable a disease as is 
membranous croup, it is right for us to resort to other mea- 
sures if they give us any prospect of success. 

He then goes on to detail several cases, in which the plan of 
treatment he pursues, is based on the following principles : — 

1. On the absence of all measures which tend to irritate 
the inflamed parts and interfere with the natural process of 
restoration, especially vomiting, which may, hindeed, give tem- 
porary relief, as it does to the distress of an inflamed stomach, 
but does not cure the disease or tend to its cure. 

2. To the absence of all depressing and debilitating reme- 
dies, as bleeding, purging, and vomiting, considered in their 
effects on the system. 



152 BIBLIOGRAPHICAL NOTICES. 

3. To keeping the patient under the full influence of opium 
combined with calomel, by which means the spasmodic con- 
traction of the rima glottidis is relieved. 

4. To the influence of external warmth and moisture, and, 
perhaps, of a slightly stimulating mercurial liniment, in pro- 
moting the suppurative process. 

5. To the constant inhalation of watery vapor, keeping the 
false membrane in a moistened condition, as it would other- 
wise become dried by the constant passage of dry air. 

Dr. W. also highly recommends the application of a solu- 
tion of nitrate of silver to the larynx, according to the plan 
so successfully recommended and practiced by Dr. Horace 
Green, of New York. The method of treatment recommend- 
ed above, if not more successful, will be found vastly more 
comfortable to the patient than the ordinary one. B. 



The Transactions of the American Medical Association. In- 
stituted 1847. Vol. iii. Philadelphia : printed for the 
Association by T. K. & P. G. Collins, 1850. 

The third volume of the " Transactions" is before us. It 
has fewer pages than the issue of 1849, but it is replete with 
interest. The reports of the standing committees of the Asso- 
ciation, with the minutes of the late meeting, occupy the 
greater portion of the work. 

Most of the reports evince a degree of laborious research 
on the various subjects within their scope, which renders them 
alike creditable to the writers, and useful to the profession. 
We regret that we have not space in our present issue for a 
more extended notice of this interesting volume, but we hope 
that every member of the profession who is desirous of keep- 
ing pace with the current history of medicine in our country 
will procure a copy. 



EDITORIAL. 



THE "REPORTER. 

Sixteen pages are added to the present number of our 
Journal. The publisher has felt himself warranted in making 
this addition, hoping thereby to secure the patronage of a 
larger number of subscribers, and to give to those who are 
already on our list, a more ample return for their money. 
With this number, are also issued printed bills for the amount 
of subscription for the current year. "We hope that subscrib- 
ers will meet this demand promptly — the printer must be 
paid, and if our liabilities can be met, it is all we ask. The 
Reporter is edited without charge, and the publisher, in the 
true spirit of professional enterprise, is willing to throw every 
dollar that he receives into the work. If the subscription list 
is enlarged sufficiently, the Journal will be enlarged. The 
increase in size will always be commensurate with the in- 
crease of circulation. We ask our subscribers then to supply 
the means, and we promise them in return, our faithful exer- 
tions to give them an equivalent. 

JAR VIS'S ADJUSTER. 

We have admitted into our Journal an article from Dr. Jar- 
vis, the inventor of the " Adjuster," which is known to the 
profession as an apparatus for the reduction of dislocations 
and fractures of the lower extremity ; in reply to a communi- 
cation from one of our correspondents published in the second 
volume of the Reporter, who made, what Dr. Jarvis considers 
unjust animadversions upon his instrument. The essay of 
Dr. Jarvis was too lengthy to admit in full, hence, we have 
taken the liberty of publishing only such parts of it as relate 
to the "Adjuster" itself ; and we do this, because we would not 



154 EDITORIAL. 

act unjustly to any one. The profession, however, in this 
section of the country, is, we think, generally satisfied with 
the employment of Desault's and Physick's apparatus, which 
has been so long used in the Pennsylvania Hospital, with 
such successful results. There is probably not an institution 
in the United States where so many fractures of the os femoris 
have been treated as in the institution referred to, and we 
think we are warranted in asserting that though the straight 
splint of Desault, as modified by the late Dr. Physick, is almost 
universally employed in such cases, and has been for a long 
series of years, the statistics of the hospital will compare favor- 
ably with those of any other as to the results of treatment ; 
we know that it is a rare occurrence for a patient to be dis- 
charged from this time-honored refuge of the afflicted with 
lameness or deformity, after having been treated for a frac- 
ture of the thigh by Desault's instrument, and while we have 
cheerfully given Dr. Jarvis an opportunity to defend the 
"Adjuster," we cannot consent that it should be done to the 
injury of a practice which has so long been acknowledged as 
true, by men whose names stand among the first and brightest 
in the annals of American Surgery. 

The Neiv York Register of Medicine and Pharmacy, 
Edited by C. D. Griswold, M. D. We welcome to our list 
of exchanges this valuable semi-monthly. The last number 
contains twenty pages, an increase of four since October 1st, 
and it is expressed as the design of the proprietor to enlarge 
its limits, as he may feel warranted in doing by an increase 
in the subscription list. The division of the work is into de- 
partments for "Medicine and Surgery," "Materia Medica 
and Pharmacy," and "Editorial Remarks." The subscrip- 
tion price is one dollar a-year, in advance. 

The American Journal of Dental Science. Edited by 
Chapin A. Harris, M. D., D. D. S., Professor of the Prin- 
ciples and Practice of Dental Surgery in the Baltimore Col- 
lege, Member of the American Medical Association, &c, &c. 



EDITORIAL. 155 

New series, Vol. i., No. 1. This is the title of a valuable- 
looking quarterly which we have not had time to peruse, but 
the receipt of which, we feel bound to acknowledge. Con- 
nected with the Journal, is a "Library" Department, the 
pages of which are now occupied with a " Practical Treatise 
on Dental Medicine, as connected with the study of Dental 
Surgery," by Thos. E. Bond, M. D. The Journal itself con- 
tains the Transactions of the American Society of Dental 
Surgeons ; a large amount of original matter, and a series of 
selected articles. 

The subscription price is $5 per annum, payable in ad- 
vance. It may be procured of Lindsay & Blakiston, Phila- 
delphia. 

The " Stethoscope, or Virginia Medical Gazette." — We 
have received a circular from P. Claiborne Gooch, M. D., 
Richmond, Va., announcing his intention to issue the " Ste- 
thoscope," on the 1st of January, 1851. We learn from the 
prospectus, that 

" Arrangements have been made at great expense, to give 
a full digest of the contents of our own as well as of the 
medical journals and transactions of England and the Conti- 
nent of Europe. An abstract from the proceedings of the 
monthly meetings of the 'Medical Society of Virginia,' will 
be given in each number, and also of such other societies and 
associations as will furnish their matter. The notices and 
reviews of scientific publications will be candid and fair, and 
the most competent aid will always be secured." 

It is to be issued monthly at $ 3 per annum, and it is to 
contain sixty-four pages. We shall be pleased to exchange 
with it. 

wood's catalogue. 

We have received from Samuel S. & William Wood, No. 
261 Pearl Street, New York, an extensive catalogue of valu- 
able works on the different branches of medical and surgical 
science, including a large collection of French works of value 
vol. iv. — 15 



156 EDITORIAL. 

and interest. We recommend his collection to the favorable 
notice of our friends. 

[communicated.] 
"DISTRICT MEDICAL SOCIETY FOE THE COUNTY OF MERCER."* 

The stated meeting of the above society was held on Tues- 
day, the 22d October, at the house of Samuel Kay, in the 
city of Trenton, Dr. Paul, President, in the chair. 

The minutes of the last stated meeting were read. 

Dr. Woolverton then read a paper on the immovable appa- 
ratus in the treatment of fractures, in which he described the 
manner the bandages, wadding, pasteboard, and starch were 
applied, the whole when dry forming a stiff and immovable 
apparatus, allowing the patient to go about upon crutches 
from the time of the accident. Dr. W., although he related 
the whole proceeding, thought there were objections to its 
use, and even its application, until the inflammation and tu- 
mefaction usually attendant on fractured bones should have 
subsided. 

The application of the gutta percha splints recommended 
by Dr. Coleman at the last meeting, entirely obviated every 
difficulty, and did away with the use of the starch apparatus. 
Dr. Coleman has been using splints made of the gutta percha 
in which holes are punched for drainage, and the carrying 
away of perspiration or other fluid, at the same time that 
they allow of cooling applications, if required. As gutta 
percha can be had of any thickness, Dr. C. cuts the splint to 
the size of the limb, and having punched the ventilating holes 
of such size and number as may be thought proper, it is then 
placed in warm water and made soft enough to take the 
formation of that portion of the limb it is designed to be ap- 
plied. On cooling it retains the exact shape, and can be re- 
moved and reapplied when necessary. 

* A friend has kindly furnished us with the following brief account 
of the semi-annual meeting of the Mercer District Society, which we 
insert here, though somewhat out of place, having been overlooked. 



EDITORIAL. 157 

There cannot be a doubt that this substance will be of great 
use to the surgeon, in enabling him to have a correct mould 
of any part to which he may wish to apply a firm support. 

Dr. Coleman read a short paper on the germination of 
wheat at low temperatures, and noticed the recent account of 
wheat which had germinated and thrown out its radicle, hav- 
ing been found impacted between blocks of ice. The question 
he wished to propose was, at what temperature would grain 
germinate ? 

It was considered that the case alluded to, threw no new 
light on the question, and the fact of the grain and its ex- 
tended radicle being found in a frozen state, demonstrated 
very plainly that germination had taken place before it got 
into the situation in which it was found. 

Dr. Paul read a very interesting paper upon the influence 
of the first impregnation on the female constitution, and its 
effect on the offspring of subsequent impregnations. Dr. P. 
first took a review of nsevi materni, or those marks which 
have been generally attributed to force of imagination, and 
then of the theory advanced by Mr. McGillivray of Scot- 
land, based upon those well-known cases to be found in our 
works on Physiology, and instances which had come under 
his own observation, where the offspring of a subsequent con- 
nection bore marks, or has exhibited peculiarities belonging to 
the male by which the female has first had fruitful intercourse. 
His (Mr. McGrillivray's) theory is thus stated : " When a 
pure animal of any breed has been pregnant by an animal of 
another breed, such pregnant animal is a cross for ever after ; 
the purity of her blood is lost in consequence of her connec- 
tion with the foreign animal." Dr. Hanney, of Aberdeen, 
has applied this theory to the human subject, and has brought 
forward some cases in elucidation. 

" Hereditary disease,'' added Dr. Paul, " has been too long 
the subject of attention for anything new to be elicited on 
this point, where certain diseases have been known to descend 
from one generation to another. But here we have the im- 
portant fact advanced, if not established, that a healthy 



158 EDITORIAL. 

female, a descendant from a healthy family, may be so con- 
taminated by fruitful intercourse with a male, diseased mentally 
or corporeally, that the issue of subsequent connections "with 
a healthy male will inherit the diathesis of the former, and 
thus produce a sickly progeny." 

" In conclusion," Dr. Paul stated, " the subject to me is 
novel and interesting, and I have considered it worthy the no- 
tice of the profession. Experiment in this case, in the human 
subject at least, cannot be instituted — the truth or falsity of 
the theory can only be proven by observation — but it is in the 
power of every medical practitioner, by keeping his attention 
awake, and an eye open to the events which happen around 
him, to watch the result of any instance calculated to throw 
light on this most interesting theory." 

OUR ECLECTIC DEPARTMENT. 

We had selected a variety of interesting articles from other 
journals which were intended for this number ; but the large 
amount of original matter which has been sent us, has crowd- 
ed most of them out : — we should like to give our readers a 
more general selection, but are at present unable to do so, 
without excluding original essays, or curtailing the reports of 
societies, &c. We hope, however, hereafter to adopt the 
plan of condensing the selected matter, by culling the most 
important materials of an essay, and presenting it in a smaller 
space. While this will increase our labors, not a little, we 
are still willing to the task when circumstances may demand 
it, in order to fill up each department of our Journal. 



ECLECTIC DEPARTMENT. 



On Nitric Acid in the Treatment of Asthma. By T. S. 
Hopkins, M. D., Waynesville, Geo. Since the spring of 1847, 
I have prescribed nitric acid in seven cases of asthma, with 
the most satisfactory and gratifying results. I was led to 
prescribe the acid in consequence of its accidental adminis- 
tration to a child, suffering from asthma, under the treatment 
of a highly esteemed medical friend in an adjoining county. 
The child rapidly recovered. He informed me of the fact, 
and I determined to test its virtues when an opportunity offer- 
ed. In adisease of such Protean form, resisting, as it often does, 
the best directed treatment of those who have grown gray in 
the pursuit of our time-honored profession, I deemed experi- 
ment justifiable, particularly when it could result in no harm 
to the patient. As to its modus operandi, in the cure of 
asthma, I have nothing to say at present. I submit the ques- 
tion to those who have a better knowledge of the pathological 
condition existing in that disease, than I profess to have. My 
knowledge of the efficacy of the remedy, is based upon facts, 
which I feel assured will convey to the mind of any one who 
may be disposed to give it a trial, the most incontestable 
proofs of its decided utility. I send you the following cases, 
with their history, as collected from the patient himself, the 
parent or the master. Cases 1st and 7th were attacked with 
asthma, on being removed to the "low lands," the one being 
free of the disease during a period of two years, the other 
twelve months. Could this be considered a relapse, or was it 
not asthma, produced, in these cases, by those causes, which 
would have caused the disease in those who had never labored 
under it before ; such as a humid atmosphere, with exposure 
to heavy fogs, walking bare-footed upon wet, low ground 
during the day, and sleeping with cold, wet feet at night. 

Case I. — Emma, negro girl, aged seven years, belonging to 



160 ECLECTIC DEPARTMENT. 

Mr. T. GL, had been asthmatic for the last three years. At 
night she suffered much from dyspnoea and cough. Slept but 
little. During the day, there was an amelioration of her suf- 
ferings, though she was never entirely clear of dyspnoea. 

I ordered five drops of nitric acid, three times daily, in a 
wineglass of sweetened water. I did not see her again until 
a half ounce had been taken. Every symptom of the disease 
had disappeared. I saw this patient in January, 1848. She 
continued well, until the last winter, when she had a return of 
asthma, which lasted a few days. Since that time, she has 
shown no symptoms of the disease. A short time previous to 
the last attack, she had been removed to a low swamp plan- 
tation. 
* * * ***** 

Case V. — W , aged seven years, son of an estimable 

friend and planter. This was the most severe case I had 
ever seen. The nightly paroxysms of dyspnoea and cough 
were most alarming and distressing, frequently threatening 
immediate suffocation. He had been treated by the most 
skillful physicians, in vain. I freely and unhesitatingly ex- 
pressed my doubts as to my ability in relieving this case. 
The acid, in doses of five drops, was prescribed three times 
daily. In a week there was a decided improvement. In a 
month he was cured. Two years have elapsed, and he con- 
tinues well. The father of this boy died during the summer 
of '49, of phthisis pulmonalis. His mother presents the 
symptoms of incipient tubercle, and his brothers and sisters, 
without exception, have been the subjects of ulcerated sore 
throat. 

Case VI. — Mrs. C , aged fifty, a resident of middle 

Georgia. She spent the summer in this place, when I was 
called to see her. Fifteen years ago, she had hydrothorax, 
from which she suffered long, and came near dying. She, 
however, slowly recovered, and after a few years' interval of 
apparent good health, she was attacked with asthma. The 
attacks were periodical, lasting about a week, and were dis- 
tressingly severe. She had tried a little of everything. I 
recommended the acid, in doses of ten drops, three times 
daily. Immediately after, she left for her home, and I heard 
nothing of her until a month since, when I received through 
a friend and relative of her's, the gratifying intelligence that 
the remedy had put a speedy stop to her sufferings, and she 
was then well. 

Case VII was a negro woman, some fifty or sixty years 



ECLECTIC DEPARTMENT. 161 

of age, belonging to Mr. R. H. She had been asthmatic for 
many years. The usual remedies had been administered in 
vain. I prescribed the acid, as in case VI. I prescribed for 
this case twelve months ago, and heard nothing of her until 
during the past week, when Mr. H. informed me that she was 
speedily, and as he thought permanently relieved, under my 
prescription; but upon removing her to the low lands, a few 
weeks since, she was exposed to a shower of rain, and the 
disease returned. — The Charleston Medical Journal and Re- 
view, Nov. 1850. 

To the Medical Profession. — The undersigned, chairman 
of the standing committee on Practical Medicine, appointed 
by the American Medical Association, May, 1850, respectfully 
solicits the co-operation of members of the Medical Profession 
in furnishing materials for the Annual Report in May, 1851. 
The duty of this committee, as defined by the constitution of 
the Association, is to " prepare an annual report on the more 
important improvements effected in this country in the man- 
agement of individual diseases ; and on the progress of epi- 
demics ; referring, as occasion requires, to medical topography, 
and to the character of prevailing diseases in special locali- 
ties, or in the United States generally, during the term of 
their service." In order to fulfill the objects thus expressed, 
the requisite data must be supplied by medical practitioners 
in different sections of the Union. This is more particularly 
true with reference to the ""progress of epidemics" and u the 
character of prevailing diseases in special localities. 7 ' Com- 
munications, therefore, are particularly desired from persons 
residing in places in which epidemics have prevailed, or in 
which prevailing diseases have been marked by special cha- 
racters during the present year. Epidemic cholera, and 
dysentery, are known to have prevailed more or less exten- 
sively in different parts of the country during the past sum- 
mer. Facts bearing upon the features peculiar to the present 
season, the production, diffusion, mortality, treatment, &c, of 
these diseases, will be acceptable. It is requested that com- 
munications upon these or any of the subjects coming under 
the cognizance of the committee, be transmitted to the under- 
signed by the first of March, 1851. 

All contributions with which the committee may be favor- 
ed, will receive due attention and acknowledgment. 

AUSTIN FLINT. 

Buffalo, New York, Nov. 1850. 

[Buffalo Medical Journal, Nov. 1850.] 











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THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. IY. FOURTH MONTH (APRIL), 1851. No. 3. 

Cases Illustrative of the Action of Ergot in Producing Re- 
tention of the Placenta. Read before the Medical Society 
of Rockland County, New York, Jan. 7, 1851. By Charles 
Hasbrouck, M, D. 

"Spasmodic contraction," or "premature contraction" of 
the cervix uteri, is referred to by obstetrical writers as an 
occasional cause of retention of the placenta; and Dewees, 
in his system of midwifery, mentions the fact, that in some 
instances of this character, the body of the uterus is also 
found to be "hard and well contracted." But so far as my 
information extends, the frequent relation between this 
condition of the uterus and the administration of ergot 
during labor has never been pointed out. The following 
cases, it seems to me, are calculated to show that such rela- 
tion does occasionally exist; that the placenta may, perhaps, 
not unfrequently, be retained by the permanent and uniform 
contraction of every part of the uterus, excited by the specific 
action of ergot upon that organ. 

Case I. — Mrs. P D , aged about 20 years, was 

taken in labor with her first child, Sept. 20th, 1842. Her 
labor progressed slowly, with pains of moderate severity, for 
about fifteen hours, when without any appreciable cause they 
entirely ceased. The vertex at this time was found occupy- 
ing the superior strait with the occiput to the left acetabu- 
lum. The uterus remaining inactive, and the soft parts being 
perfectly relaxed, I ruptured the membranes in the hope of 
reviving uterine contraction. No pains ensuing, however, 
vol. iv. — 16 



168 HASBROUCK ON ERGOT. 

couple of fingers into the os uteri. With these, I succeeded 
after considerable effort in hooking down the enclosed pla- 
centa. The patient had a rapid convalescence. 

Case IY. — Mrs. A B i aged 20 years, was con- 
fined with her first child, Oct. 22d, 1850. From the com- 
mencement of labor, the uterus acted feebly, the pains being 
extremely short and unfrequent. Her labor progressed 
slowly, however, and in twelve hours the os uteri was fully 
dilated. Her pains now became expulsive ; but the vertex 
advanced with extreme slowness, in consequence of the short- 
ness of each pain. Hoping to excite the uterus to more 
vigorous action, I ruptured the membranes; but failing in 
this, and the vertex occupying the pelvic cavity, fifteen hours 
after the commencement of labor, and three hours after the 
discharge of the liquor amnii, I gave the decoction of a 
drachm of ergot. This had the desired effect, and the woman 
was soon delivered of a fine, healthy girl. On placing my 
hand upon the hypogastrium, the uterus was found to be hard 
and well contracted. As soon as the child was separated 
from the mother, I passed my finger along the cord and found 
the placenta lying over the os uteri, which was also contracted 
to the size of a half dollar, and moderately firm. Feeling 
confident that it would be useless to wait for the spontaneous 
expulsion of the placenta; and believing that delay would 
only increase the difficulty of its manual delivery, by giving 
the cervix and os uteri more time to become permanently con- 
tracted, I at once passed my hand into the vagina, and with 
but little difficulty succeeded in dilating the os, so as to reach 
and withdraw the placenta. The woman had a good"get- 
ing-up." 

It is well known that the placenta is ordinarily detached 
and expelled, a few minutes after the birth of the child, with 
little or none of the peculiar pain that attends the parturient 
contractions of the womb. Indeed, it appears that the uni- 
form contraction of the whole uterus, the general shortening 



HASBROUCK ON ERGOT. 169 

of all the uterine fibres, the circular as well as longitudinal, 
which necessarily follows the expulsion of so large a portion 
of the contents of the uterus — in other words — the simple 
tonic contraction of that organ, is all that is usually neces- 
sary to accomplish this result. Hence arises the rule of 
practice when the placenta is retained in consequence of ute- 
rine inertia. By frictions, cold, ergot, &c, we seek to excite 
the tonic contraction of the womb. But in this, as in other 
matters, extremes occasionally meet ; and the same action of 
the uterus, which, when moderate and normal, will usually 
accomplish the delivery of the placenta, becomes, when ab- 
normal and excessive, the very means of retarding its expul- 
sion, and of rendering its delivery difficult. And such was 
the difficulty in the above cases. The uterus was not felt 
high up nor flabby, as in uterine inertia, but was found low 
down in the abdomen, and presented to the feel that marble 
hardness, which is both the evidence and result of strong 
uterine contraction. Not the least flooding was present. 
Indeed, there was no discharge of any kind whatever ; and 
I also noticed an entire absence of that alternate relaxation 
and contraction of the womb, which usually follow the expul- 
sion of the child, and which can easily be felt by the hand 
placed upon the woman's belly. In short, the placenta was 
completely encysted, and firmly retained, in consequence of 
the permanent tonic contraction of the uterus being prema- 
turely and excessively developed ; and that this premature 
and excessive contraction resulted from the specific action of 
the ergot upon the uterus, there can scarcely be a doubt. 

The action of ergot seems to be principally directed to the 
lower portion of the spinal cord, promoting in an extraor- 
dinary degree the innervation and tone of the muscles and 
tissues to which the lumbar and sacral nerves, and the nerves 
of the hypogastric plexus are distributed. This is proved by 
the benefit that results from its use in paralysis of the blad- 
der, and in partial or incomplete paraplegia ; and it is proba- 
bly by virtue of the same action that it is of such essential 



170 HASBROUCK ON ERGOT. 

service, as I have frequently observed, in the sciatic pains 
and weakness of relaxed and debilitated habits. 

The nterus, it is true, is supplied with nerves from the sym- 
pathetic system, and most probably " is not dependent upon 
the spinal cord for its power of contraction." [Carpenter.) 
This would seem probable from the fact, that delivery has 
taken place by the spontaneous contractions of the uterus, in 
cases of paraplegia from disease of the lower part of the spi- 
nal cord. But while the peristaltic or parturient contractions 
of the uterus, like the contractions of the heart, or intestines, 
may perhaps be, in a great measure, independent of its 
nervous connection with the spine ; yet its numerous reflex 
sympathies and actions, prove conclusively, that the several 
nerves of the cerebro-spinal system which pass into the plex- 
uses of the sympathetic, and are thus distributed to the ute- 
rus, are not without their appropriate influence. Indeed, it 
would seem probable, that while the peristaltic action of the 
uterus, as in ordinary parturition, is in some way connected 
with its supply of ganglionic nerves, its condition of muscular 
tonicity, or its tonic contraction may be dependent upon its 
connection with the spine. And as irritation of a motor 
nerve excites contraction in every part of the muscle supplied 
by that nerve, so the powerful influence exerted by the ergot 
upon that portion of the spinal cord from which the spinal 
branches of the uterine nerves are derived, excites every part 
of the uterus — its cervix and os, as well as its fundus and 
body — to strong and permanent contraction ; thus offering, 
as in the above cases, a very serious impediment to the pass- 
age of the placental mass. 

I am not sure that these suggestions harmonize with re- 
ceived opinions in relation to the physiology of uterine con- 
traction. But whether they do or do not, or whatever may 
be the modus operandi of the ergot, there can be no uncer- 
tainty in relation to the fact, that it possesses the property 
of increasing the tone and promoting the contraction of the 
uterine fibre. Its beneficial effects in passive menorrhagia — 



HASBROUCK ON ERGOT. 171 

that protracted and exhausting drain from the uterine vessels 
so often met with in relaxed and leucorrhoeal habits — prove 
that it is capable of increasing the innervation and organic 
contractility of the capillaries of the womb; and no one en- 
gaged in obstetrical practice can doubt its power of exciting 
the muscles of that organ to prompt and powerful contrac- 
tion, when given in the progress of labor. The contractions 
thus excited differ, however, from the ordinary contractions 
of parturition, in partaking less of a peristaltic character, 
being more constant, and effecting equally the circular and 
longitudinal fibres of every part of the uterus ; and it can 
easily be understood, that the cervix and os uteri may thus 
become so firmly contracted under the influence of large doses 
of the ergot, as to offer a complete obstacle to the delivery of 
the placenta. Indeed, I have become so entirely convinced 
of this danger, from the results of my own observation, that 
latterly, whenever I find it necessary to administer ergot to 
expedite the expulsion of the child (and particularly in first 
labors, in which the tonic contraction of the uterus is gene- 
rally more promptly and more perfectly established), I have 
at once proceeded to the delivery of the placenta, as soon as 
possible after the separation of the child. By acting thus 
early, as soon as the tonic contraction of the womb is decidedly 
developed, but before it becomes permanently and completely 
established, I have, I think, in several instances, avoided the 
difficulty which was encountered in the above cases. 

Hi-CEEsSjiDHi, N. J^ Feb. 1851. 



172 BRYAN ON RUPTURE OF SPLEEN. 



Case of Rupture of the Spleen. By William Bryan, M.D., 
late of the U. S. Army, Fellow of the Medico- Chirurgical 
College of Philadelphia. 

November 5th, 1850. Was called to see Thomas Coney, 
aged 22, who had been found on the sidewalk, about one 
o'clock A. M., prostrate and exhausted. Upon examination, 
he complained of pain in the right shoulder and left side. 
Skin cold, and covered with a profuse cold perspiration. No 
pulse at the wrist. Mind cool and collected; answered ques- 
tions rationally. I could not discover any external marks of 
violence ; and from all the symptoms occurring at the time, 
the prognosis was unfavorable. Ordered sinapisms to the ex- 
tremities, with warm applications and frictions to the sur- 
face; and otherwise following the indications, with a view of 
promoting reaction. 

6th A. M. In consequence of my absence on urgent busi- 
ness, did not see him. Dr. Trimble was called in, who carried 
out the indications as they occurred. 

At 3 P. M. he died. Made & post-mortem with the kind assist- 
ance of Drs. Trimble and Gauntt. Found the cavity of thorax 
full of blood. The heart and lungs in a normal state. No 
evidence of violence or disease. Proceeded to examine the 
abdomen, and found the spleen enveloped in a mass of coagu- 
lated blood, upon the removal of which the spleen was found 
to be ruptured in a double crucial form, and abnormally soft- 
ened and enlarged. 

Upon a critical examination of the body, the whole organ- 
ism appeared to be in a healthy state, without any other evi- 
dence than the above of violent action ; and from all the 
information that could be elicited through his family, he had 
been generally healthy, excepting a slight diarrhoea, about 
two weeks previous to his death. 

Beverly, N. J. December, 1850. 



SMITH ON TRAUMATIC TETANUS. 173 

Case of Traumatic Tetanus successfully Treated. By C. 
McKnight Smith, M. D. 

In August last, I was summoned to Mr. Abraham Woglam, 
of Staten Island, N. Y., in consultation with Dr. J. Van 
Hoevenbergh, who states the history of the case, and the 
treatment to that time, as follows: — 

July 29th. Visited the patient for the first time, and 
learned that a few days previously, in getting over a fence, a' 
sharp stick pierced his little toe. Suppuration ensued with a 
high degree of inflammation, affecting a considerable portion 
of the foot. On opening the abscess freely, a splinter escaped 
with the pus. Immersed the foot in warm water ; applied an 
emollient poultice, and directed pulv. Doveri gr. xv, to be 
taken at bedtime. 

SOth. Found symptoms of tetanus. Ordered Hyd. chlo. mit. 
9j et pulv. opii gr. iij, followed in three hours by Magnes. sulph. 
and senna. After free purging to take Hyd. chlo. mit. gr. iij, 
et pulv. opii gr. i, every three hours. 

On visiting him in the evening, found all the symptoms 
greatly aggravated. Discontinued the powders, and gave 
every three hours a tablespoonful of the following mixture : 
Antim. et potass, tart. gr. ij ; tinct. opii f^ss; aqua f^iv, 
which during the night gave some relief. 

31s£. Found the violence of the spasms so great as to raise 
the patient from the bed, his head and heels alone resting on 
it. Pulse full, frequent, strong. Took thirty ounces of blood 
from a large orifice, and continued the ant. sol. and lauda- 
num. In the evening let twenty more ounces of blood from 
the arm, symptoms continuing as before. 

On the first of August, in company with Dr. V., I saw him 
for the first time. Found him rigid with tetanic spasms. He 
had lost in a great degree the power of articulation, that of 
deglutition wholly. Was in a profuse perspiration; every 
muscle appeared involved in the spastic action, and scarcely 
a hope of his recovery was entertained. 



174 BUTLER ON MANGANESE. 

We resolved to administer chloroform. In six minutes he 
was narcotized ; his muscles relaxed, and he swallowed readily 
a tumbler of wine and water. As the spasms returned from 
time to time, the effect of the chloroform was kept up for five 
or six days, exhibited at intervals of from three to five hours. 
In addition to this, he was cupped along the course of the 
spine, and an ointment of acetate of morphia gr. v, axunge %i, 
freely rubbed in over the scarifications. Bladders filled with 
pounded ice were constantly applied to the back, the bowels 
freely opened, and the patient's strength supported by brandy, 
wine, beef-tea, &c. Under this treatment he continued to 
improve. At the expiration of ten days, he was able to walk 
about the house ; and in a fortnight after I first saw him was 
entirely recovered. 

I am not prepared to say that a cure was effected in this 
case by chloroform. It is manifest, however, that it exerted 
a most powerful influence in controlling the spasms, and thus 
enabled the attendants to administer both medicine and food. 

Perth Am boy, N. J., Feb. 1851. 



On some of the Therapeutical uses of Manganese. Read 
before the Burlington Medical Association, February 5th, 
1851. By S. W. Butler, M. D. 

The ultimate object of all scientific research and investiga- 
tion is, or ought to be, to arrive at truth and apply it to the 
benefit of mankind. In this field of boundless limits, there 
remains much, very much, both in nature and in Providence, 
which the unmatured but ever-growing mind of man has yet 
to search out. How pleasing, how ennobling the thought, 
that there is a principle in man, which is ever expansive ; and 
which, unsatisfied with present attainments, is ever on the 
alert to acquire new thoughts and ideas, and to establish new 



BUTLEK ON MANGANESE. 175 

principles which he may appropriate to his own advantage, 
and that of his fellow-man. 

Death, with disease and all our woes, is the penalty of sin, 
yet, for death, naturally the most revolting of all these, infi- 
nite mercy has provided a remedy, an infallible remedy, so 
that if misguided man will but appropriate it — will but "look 
on the brazen-serpent" — he shall live again, not for a day or 
a year, but for eternity. 

To such as appropriate this remedy, the death of the body 
is but the beginning of life, like the seed, which though it 
rots in the ground, yet has a vital principle which wakes to 
life and vigor a plant calculated to adorn and beautify the 
earth, while it contributes to its well-being, and the happiness 
of mankind. 

If then Infinite wisdom has provided a remedy for death 
itself, may He not provide, and has He not provided in nature, 
remedies, by which most of the pains and diseases which afflict 
the body may be relieved or overcome ? 

This is a proposition which the observation and experience 
of every one places beyond the need of proof. 

But man is ever learning, and, profiting by the observation 
and experience of the past, is ever adding link to link of that 
chain of knowledge which connects all past with all future 
time, and with eternity itself. Indeed, the result of the 
observations of the past fifty years is proof positive that the 
mind of man is yet in its infancy in matters even of worldly 
concern. 

It is not therefore to be supposed that we have exhausted 
nature, or ever will exhaust her in our attempts to draw from 
her vast resources materials for the relief of human suffering. 
How unreasonable, therefore, are those who are "afraid of 
new remedies," and who, content to turn their backs on the 
present and the future, are satisfied with the observations of 
the past. 

True, the Pharmacopoeia is burdened with a list of remedies, 
to learn the names and applications of which would alone be 
the work of a life-time. But why should this preclude further 



176 BUTLER ON MANGANESE. 

observation? Is there no room for improvement ? Are there 
no more materials to draw from? May not remedies yet be 
discovered which shall be so far superior to many now in use 
as to render their retention unnecessary ? 

Is it not likely that the Materia Medica list of 1851 will be 
as lightly esteemed two hundred years hence as that of 1651 
is now ? 

We think that there are many important observations yet 
to be made, and that while other things around us are 
progressing, medical science will not be a whit behind hand, 
but will advance with equal strides with its sister sciences. 

From these desultory remarks we will proceed to the subject 
of our essay, and briefly call the attention of the Association 
to manganese, in some of its forms, as a therapeutical agent. 

In doing this I but embody the results of other men's 
observations, having had no personal experience with it. 

A few experiments were made with manganese soon after 
its discovery, by Kapp, Vogt, Coupar, Gmelin, and others, 
but their observations did not seem to attract much attention. 
Latterly, however, M. Hannon and others seem to have given 
more attention to the subject, and some of their experience 
with manganese seems to entitle it to the favorable regard of 
the profession. 

TMs mineral has been found in inconsiderable quantity in 
the human organism. M. Millon found it in the blood, and 
his observations have been confirmed by those of M. Hannon. 

There are conditions of the system, when it is thought that 
iron is indicated as a remedy, and it is used with marked 
and acknowledged success. But if manganese as well as iron 
forms a part of the organism, why may not its use be indicated 
as well as the former, and why may it not alone, or in 
combination with iron, fulfill indications which the latter is 
incapable of fulfilling by itself? 

Manganese, in the form of a binoxyd, commonly called the 
black or peroxyd of manganese, is found abundantly in 
nature. Its affinity for oxygen is so strong that the metal is 



BUTLER ON MANGANESE. 177 

isolated with difficulty, and must, when pure, be preserved in 
naphtha, or it soon becomes oxydized. 

In the metallic state it very much resembles some forms of 
cast iron, and that metal is always or almost always found 
associated with it. 

So little has it been employed as a remedial agent, that it 
is barely considered as worthy of a place in some of the best 
works on Materia Medica, while recent observations seem to 
entitle it to a place of no inconsiderable importance. Pro- 
fessor Jackson, of Philadelphia, has for several years been in 
the habit of calling the attention of his classes to manganese, 
thinking it a remedy worthy of more consideration than it 
has hitherto received. In prescribing iron, Dr. J. usually 
gives manganese in combination with it. 

M. Hannon recommends various forms in which it may be 
used, such as the oxyd, carbonate, neutral malate, tartrate, 
phosphate, and iodide. 

We are now prepared to notice briefly, some of the indica- 
tions which manganese has been found to fulfill. 

1st. As a Cholagogue. Gmelin in some experiments with 
the sulphate of the protoxyd on animals, found it capable of 
producing an extraordinary secretion of bile, which was so 
considerable, that "nearly all the intestines were colored 
yellow, by it, and the large intestines had a wax-yellow color 
communicated to them." These observations have been con- 
firmed by other writers. Dr. T. H. Jewett, of South Ber- 
wick, Maine, found it a very prompt and efficient evacuant of 
the bile, giving relief in cases of jaundice, where other reme- 
dies had entirely failed. 

He thinks that " beyond any question the sulphate of man- 
ganese stands at the head of all cholagogues, doing its work 
with the promptness and efficacy of no other medicine." 
[Boston Journal, Dec. 18th, 1850, vol. 43, p. 393.) 

From half a drachm to two drachms, dissolved in half a pint 
of water, and taken on an empty stomach has been found suffi- 
cient to produce bilious stools. There has been some discre- 
pancy with regard to the quantity of the sulphate which may 



178 BUTLER ON MANGANESE. 

be taken at a dose, for while in the experience of some it has 
been found in large doses to have a powerful effect on the 
cerebro-spinal system, inducing apoplexy and palsy, others 
think it may safely be given in the dose of an ounce like 
Epsom salts. Dr. Thompson, of Glasgow, has seen it swal- 
lowed in the dose of an ounce without any other effect than 
that of a brisk cathartic. Is it not likely that in small doses 
it proves cathartic on account of the extraordinary secretion 
of bile it produces, in fact ; that it is the bile itself that is 
the real cathartic? A quack remedy to evacuate bile, the 
sel desopilant of Rouviere, was found to contain the salt in 
question. 

If these observations should prove true with regard to the 
sulphate of manganese as a cholagogue (and we think there is 
strong evidence in its favor), it is well calculated to fill a va- 
cancy in the Materia Medica which has long existed, and 
been painfully felt to exist. 

How the sulphate of manganese acts as a cholagogue is a 
very interesting question, but we will not now stop to notice 
it.* 

2d. As a tonic, manganese has been found highly useful 
in cases where other remedies, even iron, have failed to exert 
a beneficial influence. Kapp regarded it as a "permanent 
stimulant," promoting the appetite and digestion. Vogt 
places it among the tonics. M. Hannon tried its effects on 
himself, first taking the carbonate in the dose of one grain a 
day, increasing it to four grains at the end of the first week, 
and eight grains at the end of the second. At this time he 
experienced symptoms of plethora, the appetite was increased, 
the pulse became stronger, and the color of the palpebral 
conjunctiva was heightened. 

He reports several cases of anaemia from various causes, in 

* Since this address was read several of the physicians of Burlington 
have used the sulphate of manganese as a cholagogue very much to their 
satisfaction. One of them found from six to ten grains sufficient to ex- 
cite slight bilious discharges. It has been used by them in doses vary- 
ing from a few grains, to a drachm or more. 



BUTLER ON MANGANESE. 179 

which he employed the carbonate, sulphate, syrup of the 
phosphate, and syrup of the iodide, with marked success. 
He found that it frequently at first produced nausea, but the 
medicine was soon tolerated and its beneficial effects rapidly 
followed. It seemed in M. Hannon's experience to be particu- 
larly applicable to some cases of phthisis, in which complaint 
iron is often inapplicable on account of its increasing the 
cough and causing constipation. 

When it is desired to obtain the general tonic effect of man- 
ganese, we would theoretically prefer an oxyd, carbonate, 
chloride, iodide, or lactate, if such a preparation exists. 

It may be well in passing, to notice some of the toxicologi- 
cal effects of this mineral. 

Dr. Coupar noticed that when gradually introduced into 
the system, by those who are employed in grinding it, a pa- 
ralysis of the motor nerves is induced, commencing with symp- 
toms of paraplegia. This poisonous effect differs from that 
of lead in not producing colica pictonum or constipation ; and 
from mercury, in first affecting the lower extremities, and in 
not exciting tremors of the affected part. 

The above observations we think may prove worthy the 
attention of the members of the Association, and it is to be 
hoped that a fair trial of the remedy may result in a confirma- 
tion of what has been said. 

Burlington, N. J. 



BIBLIOGRAPHICAL NOTICES. 



Lunatic Asylum Reports, 

We cannot devote much space, in our monthly ; to biblio- 
graphical notices, but we have to acknowledge the receipt of 
reports of the Pennsylvania Hospital for the Insane ; the 
Boston Lunatic Hospital ; and the 

NEW JERSEY LUNATIC ASYLUM, 

with a " historical and descriptive account" of the latter. 
Our friends of Pennsylvania and Boston will not deem us too 
partial, we trust, if we pass them by without any further 
notice at present, as our own institution is the youngest, and 
requires, probably, a little more nursing. We have procured 
from Dr. Buttolph the plate of the asylum, from which we 
have had struck off the portrait of this noble institution, 
which is attached to the present number of the Reporter. 

In a few weeks the asylum will have reached its fourth 
year ; of its history since its organization, our readers have 
no doubt acquainted themselves. We have to do now, with 
its present condition. The number of patients receiving its 
benefits at this time, is one hundred and seventy-one, by whom 
the house is nearly filled ; during the past year, thirty-two 
have been discharged recovered, twelve improved, and ten 
have died. This result, which may appear less favorable 
than the statistics of former years have presented, is to be 
attributed to the increased number of chronic cases, that are 
admitted under the new law, by which the benefits of the 
institution are extended to many incurable patients who have 
been formerly under the care of township committees. 

" It should not be presumed, however, that the usefulness 
of an asylum for the insane is to be estimated alone by the 
number of those who fully recover the use of reason. In 



BIBLIOGRAPHICAL NOTICES. 181 

nearly all the institutions of our country a large majority of 
the inmates at any one period are cases of so long standing as 
to render the chances of cure but slight ; and yet the amount of 
happiness and health secured to them by the adapted arrange- 
ments of a well-ordered asylum can scarcely be conceived by 
a person not familiar with the subject. In addition to this, 
the relief given to families, friends, and even entire commu- 
nities, by the removal of this class of persons to places of 
safety, where they may receive the peculiar care demanded 
by their condition, is still another important item to be added 
to the sum of their usefulness." 

The building has been constructed and arranged for the 
accommodation of two hundred persons, but by the operation 
of the laws just referred to, a much larger proportion of ex- 
cited and noisy patients are subjected to treatment, than was 
probably contemplated at first, and hence the judicious classi- 
fication of all the inmates is materially interrupted. We would 
not be understood to complain of the law ; it is in itself a fair 
evidence of the enlightened and enlarged benevolence of our 
legislation, by which the comforts and happiness of an ob- 
scure, neglected, and incurable class of patients are secured, 
and we wish it may be extended in its most ample scope ; to 
do this, however, will require an extension of the means of 
accommodation. 

While the medical profession, the philanthropist, the Chris- 
tian, the civilian — all classes of society have abundant reason 
to rejoice on account of the improvements which have been 
already achieved in the physical and moral treatment of the 
insane, still mental disease in its various phases is on the 
increase, and there is an increasing demand year after year 
for the means of restoration. In our own State this demand 
is now made ; the claims of our suffering fellow- citizens, who are 
deprived of the care which they ought to have, are again pre- 
sented to the people ; and one of three expedients must be 
adopted to meet the present emergency — 

" Either to refuse to receive, to discharge, or both, private 

patients, to give place to those sent by the public authorities : 

to discharge chronic and supposed incurable cases, to give 

place to those of recent and more hopeful character — or, 

VOL. IV. — 17 



182 BIBLIOGRAPHICAL NOTICES. 

lastly, to enlarge the house. A few suggestions upon each 
of these alternatives are ventured, with the hope of assisting 
the members of your board and of the legislature to decide 
the question in accordance with the best interests of the in- 
sane, and that enlightened and humane policy becoming to 
the State government. 

" By admitting a portion of private patients, the sympathy 
and influence of many respectable families and individuals is 
elicited in favor of the institution, which has the effect to 
popularize it with the people and secure for it that respectful 
confidence that is necessary to its greatest success. But aside 
from this, it would appear to be the privilege of all the citi- 
zens of the State to participate in the benefits of an institution 
they had contributed to establish, when through the misfor- 
tunes of disease they require its care. 

" The discharge of chronic cases to give place to those of 
a recent character may be practiced when dictated by neces- 
sity, but the circumstances that required it are ever to be 
deprecated, as in too many instances the only remaining 
chances for enjoyment to the unhappy subject of disease is cut 
off, by their removal from the asylum and return to the poor- 
house, jail, or what is still worse, in most cases, to some 
private family, whose only accommodation is some badly or 
unwarmed out building, and whose only fitness for the delicate 
and responsible trust, that they do the work cheaply. 

" The last inquiry is whether the house should be enlarged, 
and if so, when should it be done ? In considering the ques- 
tion of extending the building, it may be proper to allude to 
the fact that the original designer, Dr. T. S. Kirkbride, a man 
of great practical experience with the insane, anticipated that 
additional rooms would be required for the excited classes of 
either sex, when the house should be nearly filled with patients; 
as the number of these were less in proportion than those de- 
signed and finished for the more quiet. The necessity for ex- 
tending the building is therefore not unexpected, although the 
period for doing it appears to be approaching more rapidly 
than was at first anticipated. In view of all the facts, it is 
therefore believed that the only question about which the 
legislature and people of the State will be disposed to hesitate 
is that of time ; and this it would appear should be determin- 
ed by the necessities of the institution, arising out of the num- 
ber and character of the patients requiring accommodation. 

" If this course of reasoning be admitted, we feel confident 
that early action will be deemed advisable, and especially 
when it is known that we have not had a vacant bed, in either 



BIBLIOGRAPHICAL NOTICES. 183 

of the wards for excited patients, during the last twelve months, 
and have constantly been obliged to associate daring the day, 
and lodge at night, from ten to twenty excited patients in the 
wards intended for the quiet only. This evil of course in- 
creases with the increase of numbers, and will interfere with 
the cure of the curable and comfort of all, in proportion to its 
extent. It should be remembered also, that the relief to be 
obtained from additional rooms must be deferred for at least 
twelve months after they are commenced ; and hence, to delay 
their commencement for one year, is practically to suffer for 
the want of them, for two years or more, according to the 
length of time required in their construction. With these 
statements of our condition and wants, the subject is submit- 
ted with the full conviction that it will receive that careful 
consideration that its importance demands."* 

To us the enlargement of the building seems the only wise 
course ; without it there cannot be that perfect classification 
of the inmates, which is not only essential as a means of cure, 
but highly important to the comfort and convenience of the 
whole household. We had hoped that the legislature of the 
present year would have made an appropriation sufficient to 
meet the present demands of the Asylum, and the claims of 
those for whose benefit it has been instituted ; and we confess 
ourselves disappointed to learn, that, after a joint committee 
of both houses had unanimously agreed upon the necessity of 
such a measure, the legislature refused to grant even such an 
appropriation as would warrant the managers in commencing 
so desirable a work. Political advantage, or the claims of 
party, should have no bearing upon an important public inte- 
rest such as this, and we do not lay it before our readers in 
this aspect. We present it as a medical question of peculiar 
and increasing weight, and we urge it upon our medical friends, 
that the profession may exert its influence in favor of the most 
liberal and enlightened policy, as the most honorable to the 
State, and the only one competent to secure the end desired. 

We feel assured that the physicians of New Jersey will 
enter into this matter as becomes their calling, and that they 
will be ready, as they ever have been, to urge the claims of 
humanity, and support by their counsel and aid the most en- 

* Dr. Buttolph's Report for 1850. 



184 BIBLIOGRAPHICAL NOTICES. 

lightened benevolence. We would urge our medical brethren 
to visit the asylum, and familiarize themselves with its ar- 
rangements and policy. The architectural conveniences of 
the building, the inimitable heating and ventilating apparatus, 
the discipline and order of the institution, are worthy of com- 
mendation, and ought to be witnessed and understood by the 
members of an enlightened profession, to whose influence and 
aid their very existence is in great measure attributable. 



Good's Family Flora and Materia Medica Botanica; contain- 
ing the Botanical Analysis, Natural History, and Chemi- 
cal and Medical Properties and uses of Plants. Illustrated 
by colored engravings, of original drawings, taken from 
Nature, by Peter P. Good, A. M., Editor of an improved 
edition of the " Memoirs of the late John M. Good, M.D., 
by Olinthus Gregory, LL.D." Quarterly, at $1 50 a year, 
in advance, or $2, with the title, glossary, &c, at the end 
of the year. 

This work is now in its fourth volume, and though we 
have never had an opportunity before of presenting it to 
our readers, we do so now with great pleasure. It is a New 
Jersey work, published at Elizabethtown, Essex Co., and 
offers to the profession, in a cheap and convenient form, an 
account of the botanical, chemical, and medical properties, 
as well as the natural history of indigenous and other plants, 
that may at all times be made available to the medical practi- 
tioner, and particularly to the country physician, in the treat- 
ment of disease. Each number contains six colored plates, 
and a mass of valuable information is condensed in a com- 
pact form, which ought to be within the reach of every phy- 
sician. The proprietor is his own engraver, printer, agent, 
and editor, and we cheerfully urge upon our readers the 
claims of his valuable production, and hope that the "Family 
Flora" may increase its circulation at least twofold. 

Address (post paid) Peter P. Good, Elizabethtown, Essex 
County, New Jersey. 



EDITORIAL. 



OUR CHANGE TO A MONTHLY. 

We furnish the present number of the Reporter to our 
patrons and friends in a new form. We have paid our visits 
quarterly hitherto, but now we appear as a monthly messen- 
ger of medical intelligence. We offer three reasons for the 
change. 1st. Some of our old friends have told us that they 
want to see the Reporter oftener, and that they would prefer 
to have it in more frequent, though they be smaller issues. 
2. We think we can secure more correspondents by remind- 
ing our friends every month that they have a medium 
through which they may communicate the results of their 
experience ; and we would hereby endeavor to stir them up to 
greater diligence in preparing matter for our columns. 3. We 
shall be able to give the current news at shorter intervals; 
and we think, on the whole, average more matter by condens- 
ing it in shorter articles. 

We hope the change will be agreeable to our readers, and 
while it adds to our labor, and increases somewhat the expense 
of the work, we shall enter upon it, trusting to the liberality 
and punctuality of our subscribers. We refer them to the 
publisher's notice on the last page of the cover. 

OUR EXCHANGES. 

We omit from this number the list of our Exchanges, but 
shall publish one twice a year. The following have not 
come to hand- 
New Orleans Med. and Surg. Journal, for January and 
March. 

Ohio Med. and Surg. Journal, for November and January. 
Medical Examiner, for February. 



186 EDITORIAL. 

The Stethoscope and Virginia Med. Gazette, for January. 
We shall be pleased to have them forwarded. 

TO CORRESPONDENTS. 

We shall be glad to receive from our correspondents any 
communications, which they may have for our next number, 
before the 15th inst. We have already " A brief Inquiry 
into some of the Causes of the Virulence and Malignity of 
the Cholera, in the Island of Jamaica," by Dr. Paul of Tren- 
ton. "Poisoned Wounds," by Geo. W. Patterson, M.D., of 
Philadelphia. " Alloepathy, a Misnomer," by James H. Stu- 
art, M. D., of Erie, Pennsylvania; which shall appear in due 
season. Several of our friends have promised to furnish 
articles, and we hope they will not forget to do so, by the 
time suggested above. 

CATALOGUES. 

We acknowledge the receipt of Catalogues of Students 
from the University of Pennsylvania, and Starling Medical 
College of Ohio. 

SPECIMEN NUMBERS. 

This number will be sent to many who are not subscribers, 
as a specimen, and we would take the liberty of saying to such, 
on behalf of the publisher, that they will not be considered 
as subscribers, and need not anticipate a bill unless they inti- 
mate their intention to become such. If they do this, we 
shall be glad to furnish them with the Reporter; but without 
such an expression, they will not be entered upon our subscrip- 
tion list. 



ECLECTIC DEPARTMENT. 



Observations on the use of Veratrum Viride in Fevers, Con- 
vulsions, fie. By Wesley C. Norwood, M. D., of Cokesbury, 
N. C. — We are always glad to give place in our Journal, so far as 
we have room, to whatever promises to be of practical value 
to the profession. Being favored with a large list of ex- 
changes, we have it in our power to select many articles 
which we would be glad to transpose entire to our columns, 
but as our space for selected matter is limited, we must be 
content to give the substance of most of the articles, in doing 
which, it shall be our endeavor to do justice to the authors. 

We insert below a portion of an article by W. C. Norwood, 
M. D., which we find among other excellent original papers, 
in the Southern Medical and Surgical Journal. 

If Dr. Norwood's experience with the veratrum viride is con- 
firmed, no one can deny that it is, in the language of a committee 
of the American Medical Association on Indigenous Medical 
Botany, " eminently deserving the attention of the profes- 
sion." Indeed, the evidence of its power to control the ac- 
tion of the heart does not rest solely on Dr. Norwood's expe- 
rience, as Drs. Tully and Osgood give their decided testi- 
mony in its favor. See an article by Dr. Osgood, in the 
Amer. Journ. of the Med. Sciences, vol. xvi. p. 296 

The remarks of Dr. Norwood, quoted below, are followed 
in the original article, by several cases which certainly seem 
to warrant their decided tone. 

If any of our readers are induced to try the remedy, we 
hope they will make known their experience with it. 

It may be well to remind the reader, that whether a tinc- 
ture be employed, or in whatever form the root is used, it 
should be fresh, as it deteriorates by time. * 

In a former communication, we stated some of the leading, 
and prominent powers and properties of American hellebore 
and its peculiar adaptation to the treatment of pneumonitis. 



188 ECLECTIC DEPARTMENT. 

We then stated, that all the powers and properties it was 
alleged to possess were true, and free from all exaggeration. 
We now go farther, and state, from the fact that some are 
disposed to doubt the validity of the assertions, that the half 
was not told. Its powers were not fully unfolded nor revealed, 
lest by giving a too glowing and brilliant statement of its 
capacity to arrest and subdue disease, it might meet the fate 
of many articles which flourished no longer than the short 
time occupied in breathing their praise. We challenge trial, 
and pledge ourselves to demonstrate at the bedside, before 
any body of physicians, every power and property we have 
heretofore claimed for it and asserted it to possess. We go 
farther, and state that all of its leading effects are so strik- 
ing that we are compelled to attribute them to the article, 
and to nothing else. We are sorry that we dwelt so long on 
the ill effects, if it can be said to possess any. It is not a 
drastic emetic in the sense that tartar emetic is said to be. 
Its nauseant powers are the most disagreeable of any effect 
belonging to it. From the description given, we learn that 
it deterred many from using it, and led others to question its 
usefulness. We deemed it far more prudent to enter fully 
into any unpleasant effects, than to keep them concealed, and 
present nothing but its prominent beneficial effects. We now 
boldly hazard the assertion, that it is the only article or agent 
known that will control certainly, and without disappointment, 
the action of the heart and arteries — that it is the only thera- 
peutic agent known through which we can say to the heart and 
arteries, so fast shalt thou beat or pulsate, and no faster. We 
unhesitatingly assert, that it has not failed us in a single case 
to reduce the action of the heart and arteries, down to any 
point we wished, as to the number and frequency of pulsa- 
tions. We believe that it will be eminently useful in every 
disease in which increased frequency of the action of the heart 
and arteries take place to any extent. We also believe that 
when its powers are fully ascertained, tested and developed, it 
will produce an era in the treatment of disease. 

We have no doubt that veratrum viride will prove a valua- 
ble agent in the treatment of scarlet fever. We stated in our 
former article in this journal, that veratrum viride certainly 
reduced the frequency of the pulse — that it produced the most 
intense paleness of the surface, and unusual coolness or cold- 
ness of the surface, accompanied with more or less moisture. 
In scarlet fever, we know there is unusual frequency in the 



ECLECTIC DEPARTMENT. 189 

pulsations of the heart and arteries ; also, that there is great 
heat and dryness of the skin, and congestion, if not inflamma- 
tion, of the capillary system. Veratrum viride eminently sub- 
dues, overcomes and removes every condition we find to exist 
in scarlet fever. In scarlet fever there is often more or less 
mucus in the fauces and trachea, and ulceration and inflam- 
mation often exist. Veratrum viride, by its emetic effect and 
acrid properties, will remove the mucus and change the action 
in the fauces. In scarlet fever, the heat, redness and dryness 
of the skin are extreme. Veratrum viride produces coolness, 
paleness and moisture of the surface ; thus certainly relieving 
all these annoying conditions, and affording to the patient every 
opportunity of comfort and relief. — Southern Medical and 
Surgical Journal, Jan. 1851. 

Leaves of the Ricinus Communis as a Gf-alactagogue and 
Hmmenagogue. By Dr. Tyler Smith. — It appears from a 
paper read before the medical section of the British Associa- 
tion, by Dr. M' William, that the leaves of the castor oil plant 
possess an undoubted power of exciting the action of the 
mammary glands as well as the uterine system. He tells 
us that the native women, when the milk is delayed, make 
a decoction of the leaves, with which the breasts are freely 
fomented ; the leaves are thinly spread over the bosom and 
allowed to remain till all moisture is evaporated. The truth 
of this alleged property of the plant has been also tested by Dr. 
Tyler Smith, with leaves gathered in the botanical gardens 
of Chelsea, and several cases are reported from which we 
make the following selections : — ■ 

Mrs. C, aged 24, had weaned her child about six weeks, 
but had still a little milk of a thin serous character. She 
commenced the use of the plant by bathing the left breast 
only, with a strong decoction of the leaves, which were like- 
wise applied as above mentioned. After a few applications ? 
the milk had become much more thick. 

Mrs. H. had weaned her child more than six months. On 
careful examination little or no milk could be discovered in 
either breast. The plant was used night and morning for four 
days. After the second application, thick milk like colostrum 
could be squeezed out from both breasts, which had become 
tinged. A leucorrhoeal discharge was also produced. 

When it is required to induce the catamenial discharge the 
patient is directed to sit over the steam from a decoction of the 



190 ECLECTIC DEPARTMENT. 

plant, and to bathe the vulva and thighs, as well as the breasts. 
— Western Lancet, from Prov. Med. and Surg. Journal. 

Abortive Power of Collodion on Small-pox. — A case has 
recently occurred in the wards of M. Aran, at the Bon Se- 
cours, in which the good effect of collodion was proved to be 
as decisive in confluent small-pox as it had been found before 
in the more simple form. It occurred in the person of an 
unvaccinated young man, and the collodion was applied to all 
parts of the face but the lips and ears. Through this trans- 
parent covering the progress of the pustules was observed to 
become at once arrested, while those uncovered continued en- 
larging. Moreover, a part of the covering having been de- 
stroyed without being observed for some hours, the pustules 
thus exposed immediately began to develop themselves until 
again arrested by a reapplication. The ears, too, were now 
covered, and the progress of the pustules stopped there. In 
a few days the collodion peeled off, the skin looking as after 
erysipelas, but no cicatrices were to be observed, though in 
other parts of the body they existed in abundance, the erup- 
tion having been very confluent. — Brit, and For. Med.- 
Chirurg. Review, from Bull, de Therap. xxxix. 369. 

On the Treatment of Hooping -Cough by Cochineal. — 
A correspondent of the N. Y. Medical Gazette, writing from 
Port Chester, N. Y., has had satisfactory experience in the 
use of cochineal in hooping-cough. He uses it in larger doses 
than have heretofore been recommended. The following is 
his formula for its preparation. Cochineal in very fine pow- 
der, 3ij ; Carbonate of potash, 3j ; Sugar, Ij ; Tinct. of 
spearmint, f^ij ; Water, fjfxiv. — Mix. Dose. — A teaspoon- 
ful three times a-day, without regard to age. According to 
his observation, it injures by being kept long. 

He says, " When commenced with early in the disease, it 
never fails to render it mild throughout, though it does not 
seem materially to shorten its duration ; nor does it seem 
to exert any decided control over those aggravated cases where 
its early employment has been neglected." — i\T. Y. Med. 
Gazette, Jan. 1st, 1851. 

In our experience, alum has proved very useful in this 
troublesome complaint. We have been employing it very 
satisfactorily for some time in most cases, in the following 
formula ; recommended, we believe, by Dr. Golding Bird. 



ECLECTIC DEPARTMENT. 191 



R. — Alumen, 

Ext. conium, 
Syrup, papaveris, 
Aqua anethi, vel 
" feniculi, . 



gr. xxv ; 
gr. xij ; 

f^iij.-M 



Dose for an adult, a dessertspoonful every six hours. 



* 



Case of Luxation of the Penis. — This curious case occurred 
in a lad aet. six, who fell from a cart. He was treated for the 
resulting contusions for some days, when it was observed that 
urine passed through a wound near the left buttock, and he 
was sent to the St. Louis. M. Nelaton, on taking hold of the 
penis to pass a catheter, was astonished to find it quite destitute 
of substance, giving him the same sensation as the skin of a 
silkworm after the insect has quitted it — a mere cutaneous 
tube bent upon itself. Feeling for the missing penis, he found 
a firm resistant body in the scrotum, which he recognized as 
the corpus cavernosum and glans, all the essential parts of the 
organ having thus remained in the scrotum for nine days. 
He introduced Sir A. Cooper's instrument for tying deeply 
seated arteries, through the cutaneous tube, and conducting 
the hook under the corpus cavernosum, seized this crosswise, 
and by a to-and-fro movement succeeded in replacing the 
organ. An incision was made in perineo to facilitate the 
evacuation of the urinary deposit which had occurred from 
the rupture of the urethra ; and at the time of the report the 
child had not yet passed any urine by the natural channel. 

As arising in a somewhat similar manner with this accident, 
viz., through the agency of a sudden compression, a case may 
be mentioned that was admitted some time since into the Hotel 
Dieu, in which one of the testes was forced along the corpus 
cavernosum just under the skin as far as the glans. It was 
very easily reduced, and at the autopsy it was found that it 
had not become separated from the cord. — Q-az. des Hop., 
No. 86. 

Operation for Ingrowing Toe-nail. By M. Baudens. — M. 
Baudens states that he has performed the following operation 
more than 200 times without accident of any kind, little pain 
being caused, and that only for a few seconds. The right 
hand is armed with a narrow, straight bistoury, held like a 
knife while cutting a pen. The free extremity of the toe is 
firmly fixed by the thumb and index finger of the left hand, 
so as to render the diseased part prominent. The operator 



192 ECLECTIC DEPARTMENT. 

now carries the edge of his knife (on the outer or inner side 
of the phalanx, according to the situation of the disease, and 
equidistant from the root of the nail and the next phalanx) 
perpendicularly down to the bone, and then inclines it towards 
himself, shaving the phalanx, and carrying off at one stroke 
the degenerated soft parts, the diseased portion of the nail, 
and the corresponding portion of the matrix — the removal of 
this last being indispensable, in order to render the reproduc- 
tion of the disease impossible. For two or three days he keeps 
the parts surrounded by ice (which, however, is no essential 
part of the plan, but his mode of treating recent wounds in 
general), when granulations spring up, and eventually a horny 
description of cicatrix, forms an excellent substitute for the 
nail. — Cf-az. des Hopitaux, No. 77. 

On the Diminution in Weight of Neiv-born Infants. By 
Dr. Hoffman.— It is a popular opinion that new-born chil- 
dren fall away during the early days after birth, and seeing 
that during this period they evacuate meconium, the epider- 
mis exfoliates, and matters are expired from the lungs, while 
the little milk they take is little else than a purgative colos- 
trum, there is reason for its entertainment. To test it prac- 
tically, however, Dr. Hoffman had thirty-six children, who 
were successively born at the hospital at Wlirzburg, weighed 
every morning ; and in the present article he gives the tabu- 
lated results of the daily examination, from which the general 
conclusion is drawn that all children for the first thirty-six 
or forty-eight hours after birth become lighter, such diminu- 
tion in the majority continuing until the third day. From 
this period they increase again, so that by the fifth or sixth 
day they have in general recovered the weight they possessed 
at birth. — Neue Zeits. f. Greburt., b. xxvii. p. 145. 

On the Cause of Abscesses pointing towards the Shin. By 
Charles W. Wright, M. D., of Cincinnati. — The cause of 
abscesses pointing towards the skin has long engaged the at- 
tention of pathologists, and various explanations have been 
offered, the most plausible of which is that in coming towards 
the skin they meet with less resistance than in passing in any 
other direction. 

That this is an insufficient explanation in almost all cases 
is evident, for pus has been known to remain for days and 
even weeks in immediate contact with the peritoneum, without 
having the least disposition to pass through that structure. 



ECLECTIC DEPARTMENT. 193 

Now, when it is remembered that the motion of the fluids 
of the animal body are governed mainly by chemical laws, 
it would not appear to be such a difficult matter to explain a 
result so general as that above mentioned by those laws. 

Liquids are attracted towards each other through a mem- 
brane or porous structure with a force proportional to the ca- 
pillary or chemical affinity which they have for each other, 
and for the interposed membrane. As the skin in a state of 
health is always bathed with a secretion which is acid in its 
reaction, it follows that if it be placed in contact with a fluid 
of an opposite nature, they would have a tendency to inter- 
mix the amount of fluid remaining the same on either surface, 
if both fluids have the same affinity for the interposed sub- 
stance ; but if the attraction of the one exceed that of the 
other, for the skin, and was also in relation with the atmo- 
sphere, by which evaporation could go on, and facilitate the 
motion of the current in that direction, the ultimate effect 
would be the establishment of a flow tending almost exclusively 
to one point. 

This would appear to be the cause of pus tending towards 
the surface of the body. For although when healthy its re- 
action towards test paper is neither that of an acid nor alkali, 
still when we look at its chemical constitution, we find it to 
be really alkaline in its nature. 

The membranes lining the serous and mucous cavities, being 
bathed in a secretion that has an alkaline reaction, would of 
course have little or no attraction for a fluid possessing the 
same generalities. On the other hand, the secretion of the 
skin having an acid reaction, would have a strong attraction 
for a fluid possessing opposite properties, being assisted at the 
same time by the evaporation which is constantly going on 
from the surface of the body. 

That the cause of abscesses pointing towards the surface is to 
be explained on the principles of endosmosis, would appear 
from the treatment which is adopted in these cases. If it be 
wished to promote suppuration and expedite the passage of 
the abscess towards the surface, light poultices are had re- 
course to. They relax the skin and promote perspiration. 
The very conditions calculated to favor endosmosis. They 
have to be frequently renewed, lest they become dry, by which 
evaporation would be arrested. The applications must be 
warm. Heat promotes endosmosis. 

If absorption be desired, cold lotions are used. Cold re- 
tards endosmosis. Mercurial plasters are recommended. 



194 ECLECTIC DEPARTMENT. 

These by arresting evaporation reverse the current of fluids 
passing to the surface. A blistered surface operates in the 
same manner. Purgatives by diminishing the cutaneous eva- 
poration have the same effect. Pressure accomplishes the 
same object. 

A careful study of the laws of endosmosis cannot fail to 
convince any one that the cause of abscesses pointing towards 
the skin is to be explained on the principles of endosmosis, 
and not by their meeting with less resistance in that direction 
as is generally supposed. [ Western Lancet. 

Yeast in the Treatment of Malignant Scarlet Fever. — Sir : 
In your number of the 20th inst., I have read "An Account 
of a Recent Epidemic of Scarlatina," by Dr. Helfft, wherein 
he mentions several anomalous features which that disease has 
presented in different parts of Grermany. Now, I also have 
seen cases in this town and neighborhood somewhat similar, 
and, like Dr. H., "deem it my duty to lay before the profes- 
sion" the plan of treatment I pursue. 

I have not had any opportunity of making (like Dr. H.) 
post-mortem examinations, because I have not lost any of my 
patients since I commenced the treatment I will mention. 

At present, and especially during the epidemic of scarlet 
fever in 1847, I have found the administration of fresh yeast 
of the most invaluable advantage when the symptoms are of 
that anomalous character which Dr. Helfft describes, or when 
the disease assumes its most maligna7it form. After ammo- 
nia, the mineral acids, chlorate of potash, &c, have failed, 
and the application of nitrate of silver besides, one or two 
tablespoonfuls of fresh yeast frequently given (according to 
the age and malignancy of the case) has, in my practice at 
least, been so quickly efficacious as an antiseptic and stimulant, 
that I have, from the circumstances before alluded to, been 
induced to send you this short communication, and in the hope, 
also, that the remedy may be fairly tried by others. 
I am, sir, yours obediently, 

Francis Bennett. 

Gateshead, Dec. 28th, 1850. 

\_JY. Y. Reg, of Med. $ Pharm. From Lond. Med. Gfaz. 

American Antidote against Snake Poison. — The seeds of 
the Simaruba Cedron, obtained from Panama in South Ame- 
rica, have recently attracted considerable attention in France, 
and a congress of medical men was announced to be held in 



ECLECTIC DEPARTMENT. 195 

January last for the purpose of testing by experiment the 
virtue of this celebrated remedy, and M. Auguste Guillemin, 
and M. Hyppolyte Fournier, Professor of Mathematics of the 
department of Arvegron, had offered themselves to be operated 
upon. The Governor of Panama has addressed a letter to 
Dr. Peter Smith, of the City Hospital at San Francisco, con- 
firming the experience of the native physicians at Panama. 
For internal use, the scrapings of the fruit are given in five- 
grain doses, in spirits or warm water, and at the same time the 
wound, if from the bite of a venemous reptile, is washed with 
an infusion, and covered with the scrapings, secured by a 
bandage. 

The remedy is said, also, to have been successfully used in 
cases of retained placenta, and as a substitute for Quinine in 
the treatment of malarious fevers, and it is proposed as a 
remedy for mental diseases and epilepsy. Dr. Smith, of San 
Francisco, uses this remedy in dysentery and intermittents, 
in doses of ten or more grains. The Medical Examiner, of 
Philadelphia, contains drawings of the cedron pod and seeds, 
by G. R. B. Homer, M. D., U. S. A., with remarks upon this 
subject, from which we make this abstract. [Ibid. 

A Case of Rupture of the Uterus during Delivery, in which 
Turning was resorted to, and subsequent recovery of the pa- 
tient. By CD. Griswold, M. D. — We have taken some pains 
to learn the particulars of this very remarkable case, which 
occurred in November last, in the care of Drs. Maxwell and 
Lindsley, of this city. 

The patient, aged 29, and of a somewhat strumous habit, 
entered on her third accouchement, and progressed until the 
head pressed upon the perinaeum, without anything unusual 
occurring. While in this stage of labor, she felt what she 
termed a "cramp in the bowels," and complained of an un- 
comfortable sensation, from which she desired to get up off the 
bed, and did so, and walked across the room two or three 
times, with an assistant. On her resuming again the re- 
cumbent posture, Dr. Maxwell made an examination, 
from which he discovered that the head had receded, which, 
together with the pulse at 120 per minute, and the entire 
absence of labor pains after what she called the cramp, and 
the returning discomfort in the umbilical region in this posi- 
tion, he was immediately impressed with the true nature of 
the case, although the patient again got up, and was seated 
for some time in a chair. Conferring with Dr. Lindsley, it 



196 ECLECTIC DEPARTMENT. 

was decided to at once turn and deliver. The hand was passed, 
and the feet reached through the rupture in the uterus — among 
the viscera of the abdominal cavity— and brought down ; but 
not without considerable difficulty was the patient delivered of 
a full-grown child, which had apparently been dead for some 
hours, and with it the placenta. Dr. Maxwell then passed his 
hand, with the view of removing any clots of blood which might 
have accumulated in the peritoneal cavity; but discovering 
none, he felt distinctly the intestines and omentum in situ. 
Dr. Lindsley made the same investigation, and with the same 
result. 

The patient at this time was very much prostrated ; pulse 
120 per minute, and weak. Stimulants were immediately re- 
sorted to, and administered at the rate of a pint of brandy in 
punch each twenty-four hours, but without any signs of reac- 
tion until the end of the second day, when the abdomen became 
tympanitic, with a tumor in the right iliac region, extremely 
tender on pressure, yet the pulse remained soft, and not in- 
creased in frequency. A large blister was placed above the 
umbilicus, with the view of applying leeches or cups below, 
which, however, were not resorted to. Stimulants were freely 
administered for two weeks, with beef tea, chicken soup, etc., 
while the pulse remained compressible through the whole time ; 
and what may be considered most of all remarkable is, the 
patient was out in the street in four weeks and menstruated 
on the ninth, and remains in good health to this time. 

We give thus briefly this remarkable case from recollection, 
having simply heard the more important points stated, but 
understand that it is to be published in full in the New York 
Journal of Medicine. — \Ibid. 



THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. IV. FIFTH MONTH (MAY), 1851. No. 4. 

A Brief Inquiry into some of the Causes of the Virulence and 
Malignity of the Cholera in the Island of Jamaica. By 
Jas. Paul, M. D. ? Trenton, N. J. 

[Read at a meeting of the " District Medical Society for the County of 
Mercer," January 28tb, 1851.] 

It is at all times interesting to the medical observer, to 
note the phases of disease in every land ; and the subject is 
forced upon us at the present time with a twofold interest, 
when we hear of an epidemic, fearful even in its mildest 
form, sweeping with terrific violence an island so neighbor- 
ing, we may call it, to this continent, and with which a 
commercial intercourse is so constantly kept up. And while 
the devastation and the awful loss of life attendant on its 
progress in that island, more fatal perhaps than in any other 
portion of our habitable globe, is reported to us, we are in- 
sensibly led to inquire into the cause of this fearful mortality, 
and to what can be attributed the aggravated and severe form 
the disease has assumed. 

The Island of Jamaica, it will be recollected, lies within 
the tropics, being situated between 17° 89' and 18° 36' north 
latitude, while a line drawn due south, strikes Washington in 
this land, and Kingston its chief city — lying between 76° 3' 
and 78° 34' longitude west of Greenwich. The sun in its 
course passing over the island twice, and proceeding little 
more than 5° farther north, gives the extreme heat of the 
tropics, and part of the time of a vertical sun, for at least five 
months of the year — which would be insupportable, but that 
vol. iv. — 18 



198 PAUL ON CHOLERA IN THE ISLAND OF JAMAICA. 

it is tempered by the sea breeze by day, and the land wind by 
night — the cone-like formations of the mountain ranges ex- 
tending from east to west, causing the hot air to ascend in 
the centre, which again returns with some force, whenever 
the influence of the sun's power is withdrawn. 

In the lowlands of Jamaica, on an average of all the year 
round, the thermometer may be stated as standing at 86° at 
noon ; rising in the summer months to 89° and 90°, not often 
higher, and in the cooler months to 84° and 85°, descending 
at night to 76°, and sometimes to 68°, seldom lower; the 
heat of the higher mountains ranging from 10 to 15° lower 
than the lowlands ; while the barometer rarely fluctuates 
during the year more than two-tenths of an inch — say from 
29.80 to 30.00, except on particular occasions; the rainy 
seasons being May and October. 

In a climate where perpetual summer reigns, and vegeta- 
tion is ever luxurious ; where miasma is constantly generated, 
and noxious vapors are borne on the laden atmosphere ; and 
where the rain as it descends, carries with it, as it falls upon 
the unprotected traveler, disease and death ; can we wonder 
that a disease so pestilential in its character, so rapid in its 
course, prostrating the individual, and leaving no time for 
remedial efforts to have effect, should spread dismay and 
horror amongst all classes of the inhabitants ? 

The human frame is happily constituted, and capable of 
being moulded and changed so as to accommodate itself to 
any climate ; hence we find that individuals from a northern 
climate, on their first arrival in the tropics, are seized with 
fever. This fever is generally in the first place of the bilious 
remittent character, and in its progress, according to the con- 
stitution of the individual, and of course from other causes, 
assumes its type — in some with perfect remissions, in others 
approaching typhus, and in others ending in black vomit, 
with the other characteristics of yellow fever ; such cases 
of yellow fever being entirely sporadic, and by no means 
liable to become epidemic. In this acclimating fever, the 
weaker frame has much the advantage of the robust, and 



PAUL ON CHOLERA IN THE ISLAND OP JAMAICA. 199 

consequently women have a better chance of passing through 
the ordeal than men, A complete change is, however, 
wrought. In women, however high the rose may have tinted 
the cheek, it henceforth is no more seen — in man, his 
strength of constitution is impaired; the least exertion causes 
the perspiration to roll from his body; but, although his 
firmness of muscle is reduced, he can undergo more fatigue, 
he can bear exposure to the sun with less inconvenience, 
and he is not so easily affected with the noxious vapors of the 
night season. 

Of the colored population — I allude to the browns and 
blacks — I may state that the former are, for the most part, of 
delicate make, having little strength of constitution. But 
while I speak thus of that portion of the population gene- 
rally, of course there are many strong, able, and athletic. 
The late distress of the island, too, has made many fare hard. 
Never hearty eaters of good substantial food, they subsist for 
the most part upon a vegetable diet, the produce of the coun- 
try, made palatable with the indigenous spices, and a small 
portion of salted food, either pork or fish. Similar to this, 
may be said to be the food of the black population ; while 
neither, therefore, are robust nor very strong, yet they are 
enabled to endure much fatigue. 

Disease in such a climate runs its course with fearful 
rapidity. A few hours lost, and the patient slips through 
the hands of his physician. There is no time for delibera- 
tion ; but prompt and energetic must be the practice, if a 
chance of saving life is to be expected. 

With such a climate, and among such a population, can we 
wonder at the havoc, the dreadful mortality which has ensued 
from a visit of that formidable disease, which in every part of 
the world has swept its thousands from the face of the earth ? 
We must recollect, too, that when cholera pursued its devas- 
tating course over this continent in 1832 ; and when it visited 
some of the West India Islands and ports of Central America, 
at no great distance from Jamaica, thinning the population 
wherever it made its appearance, that island was happily 



200 PAUL ON CHOLERA IN THE ISLAND OF JAMAICA. 

saved from its ravages. It runs its present course, therefore, 
with redoubled fury, and neither age, sex, nor color has been 
safe from an attack. Neither has any place or location been 
secure — the valley and the hill, the lowlands and the moun- 
tains, above the line where tropical fevers have been known 
to pass. No place has been safe from its approach. 

In no country, and in no climate, has the disease mani- 
fested itself under circumstances more aggravated, or where 
the mortality has averaged so high in proportion to the 
amount of population. What the average mortality to the 
number of cases may be, we have no accurate means of 
ascertaining ; but under the circumstances, where in some 
districts no medical aid could be obtained, where the sick 
and dying were deserted by their nearest friends ; in a climate 
where miasma and noxious gases are ever being generated, 
where the process of decomposition and putrefaction com- 
mences almost on the instant that vital action has ceased to 
exist; where the constitution is weakened, and without the 
vis medicatrix naturae which enables the frame to resist the 
influence and approach of the disease ; laboring under the 
depressing influence of seeing those around them suddenly 
struck down, neither sex nor age being spared, and this not 
singly, but whole families, a few hours only being the period 
for the disease to run its course, we can scarcely be surprised 
at the panic it occasioned, or the horror which overtook the 
more timid. Such results were enough to horrify and make 
falter the stoutest heart. 

Of the virulence of the disease we may state, that while 
three to five hours only was the usual time for the disease to 
run its course, yet a period of two and three hours was com- 
mon. A correspondent from the parish of St. James' on 
the north side of the island says : — 

"There has been dreadful mortality at Latium Estate. Upwards of 
120, it is said, have fallen victims to the disease. The property is almost 
depopulated, there being, we understand, but the remnant of two or 
three families surviving. So malignant was the pestilence there, that 
able-bodied laborers, in robust health, while employed in the manu- 
facturing process, were seized with cramps and spasms, and in a short 
space of time became lifeless matter." 



PAUL ON CHOLERA IN THE ISLAND OF JAMAICA. 201 

Another, alluding to the disease at Spanish Town, the seat 

of government, says : — 

" The virulence of the disease is remarkable. The body of a person 
who had died of it was taken out of town, and as usual, the negroes 
held a wake over it, which caused the greater part of them to lose their 
lives." 

The disease first made its appearance at the town of Port 
Royal, about the beginning of October, when 430 out of a 
population of 900, fell victims. A letter dated Spanish 
Town, Nov. 5th, marks its progress. The writer states : — 

" The country is in a dreadful state. The cholera is raging fearfully 
here, and is of a very malignant type. No tongue can depict the misery 
it has inflicted in the parishes it has visited, viz., Kingston, St. Cathe- 
rines, and Port Royal. Neither sex, age, rank nor color have escaped, 
and no one can tell where it will stop. Whole families have been swept 
out of their houses in one day. We have had a great deal of rain 
during the season, which has undoubtedly done much towards vitiating 
the atmosphere. 

" The disease generally attacks people during the night time. The 
medical men of the town are completely worn out." 

In the city of Kingston, the disease continued its ravages 
for about eight weeks, during which period, from 5000 to 6000 
persons fell victims out of a population of 35,000. 

The following extracts of letters from the parish of St. 
Mary, show the alarming manner in which the disease mani- 
fested itself. In a letter dated 2d December, 1850, the 
writer says: — 

" The epidemic descended on Port Maria yesterday, and its effects 
were truly awful. I trust in God never to witness such a scene again 
in the little town and suburbs. There was scarcely a house in which 
there was not either a dead or dying person, and in several four or 
five. Whole families were swept off in the course of a few hours." 

And another of the 10th of December, the writer states: — 

" The cholera is indeed making dreadful havoc here. From the 30th 
ultimo, to date, there have been 430 deaths — a little more than one- 
third of its inhabitants. The first house it entered, in less than ten 
hours, twelve out of fourteen fell victims, and since then, two or three 
hours' illness, in almost every case, have been the extent — when death 
ensues. The dead have laid in the burial-ground for days, uncovered — 
sometimes as many as fifty. The result has been instantaneous death 
to several grave-diggers." 

A later communication states : — ■ 

'•' The disease has disappeared from Port Maria, having left about 
250 souls surviving out of a population of 1000. Nor has the mortality 
in the rural districts been less fearful." 



202 PAUL ON CHOLERA IN THE ISLAND OF JAMAICA. 

The following extracts of the progress of the disease and 
incidents connected with this awful visitation, can scarcely be 
read without exciting the deepest interest and sympathy. 

A correspondent from the parish of Yere, states : — 

" At Braziletto estate, no less than fifty people had died in the short 
space of forty-eight hours. 

"The writer says: — Yesterday (Monday) morning I went accom- 
panied by two gentlemen connected with the late and present Board of 
Health to visit the burial-ground attached to Braziletto Hospital. We 
found seven unburied corpses lying on the ground in coffins, and carts 
constantly conveying bodies for interment. Twenty other bodies, in 
the hospital, and in the negro houses adjoining, had been, and were at 
that moment, uninterred since Friday last. The John Crows were in 
numbers about the place, and the scene altogether was one of horror. 
This morning (Tuesday), in consequence of the inability to ' bury the 
dead, those negro houses which contained ^tdead bodies were burned to 
the ground with the bodies in them ; and as regards the corpses in the 
hospital, which it was intended should be completely covered with lime, 
as no one could be found to remove them, so no one could enter the 
room in which the bodies lay for that purpose, on account of the horri- 
ble effluvium." 

" St. Elizabeth. — ' The infection/ says a gentleman writing from the 
interior of the parish, ' is traced distinctly from the town into the middle 
quarters district about two miles from Holland on the Black River road, 
and has been extremely malignant, a few cases only having recovered, 
which Dr. King attributes to the constitution of the negroes; for 
although he says the medicines have in some cases conquered the dis- 
ease, the system would not rally, and people have died in the act of 
eating cocos shortly after the attack. No after care is attended to, and 
the stay of the doctor is necessarily limited to the prescription and ad- 
vice/ " 

From the parish of Trelawny, the clergyman writes : — 

"At first the mortality was frightful, but the type of the disease is 
milder now, and when patients are attended to, the disorder yields to 
medicine. I can confirm by my own observation all that is said of the 
heartlessness and want of natural affection among the negroes. The 
moment they are seized, if the relatives do not abandon the patient, 
they lay him on the floor, strip off any good clothes, and think the pro- 
bable loss of the bed by the patient dying in it of much more conse- 
quence than the loss of the patient's life." 

The editor of the " County Union" published in the parish 

of St. James, writes: — 

" We cannot write for our journal, for however mortifying the acknow- 
ledgment, our heart is but soft and human, and we are totally unmanned 
by the awful scenes of death and misery of which Montego Bay is one 
immense assemblage — a mammoth hospital, sending out its dead for 
burial — with no time for mourning — no power for woe to vent itself, or 
for the pent-up feelings of our nature to indulge in tears. No sooner 
is one inmate of a family removed by death, than another victim is 
selected by the fell destroyer, and corpse after corpse attests the fearful 



PAUL ON CHOLERA IN THE ISLAND OE JAMAICA. 208 

power of the pestilential scourge with which we are afflicted. "What 
then can be expected from an editor? Can the public seek for the 
coinage of his brain, when his very thoughts are tinctured by the char- 
nel house, death standing at his elbow, and the pen trembling with 
emotion as he writes ? 

"In the district in which we operate maybe seen some thirty or forty 
dwellings — doors and windows open — tenantless — lime strewn — each 
one a witness of death ; all a testimony of our suffering ; while at intervals, 
where as yet some inmate is alive, is written on the door — ' Lord have 
mercy upon us ! Christ have mercy on us !' and pen can neither write 
nor tongue describe the melancholy feelings of horror or the cold shud- 
der of dismay which creeps over the spectator, as, unwillingly, he is 
forced to witness what the mind involuntarily tells him he is passing 
by, and which it is in vain to close the eye against." 

It is computed that not less than 30,000 souls have fallen 
victims to the epidemic. This, out of a population of 350,000, 
gives one in llf of the whole number of persons upon the 
island. The average mortality to the number of cases, it will 
be extremely difficult to obtain any accurate knowledge of, 
the different localities varying so much. I cannot omit here 
the mention of those of our medical brethren who have fallen 
a sacrifice and have lost their lives in the prosecution of the 
arduous labors entailed on them. The names of the follow- 
ing have come to my knowledge : Drs. McFadyen, Palmer, 
McDerinit, Tabois, Tait, Fishborne, Bailey, Merrick, Ewart, 
Cooke and Creighton, all gentlemen of eminence in their pro- 
fession. 

I shall detain you but shortly, while I offer a few observa- 
tions on what must appear strange to those unacquainted with 
the state of that island, when they read of whole districts of 
country being depopulated, having had no medical aid on 
which they could call for assistance. 

At the period of the abolition of slavery, perhaps no por- 
tion of the population suffered more by the great change than 
the members of the medical profession. During slavery, the 
proprietor of an estate or plantation not only remunerated 
the medical attendant, but provided an hospital, where the 
sick slave was received and every attention paid to his case ; 
medical attendant, nurse, medicines, and nourishment, were 
all found for him. The relatives of the individual were in no 
way called upon to contribute to his wants ; and if the slave 
died, he was buried at the master's expense. The change 



204 PAUL ON CHOLERA IN THE ISLAND OF JAMAICA. 

from slavery to freedom completely altered this state of 
things; the relative position of master and dependent ceased; 
the chain which bound them , not only of slavery but of 
interest and affection, was snapped ; the laborer would own 
no master; and all that the proprietor of an estate was 
called upon to do was to pay the laborer for work per- 
formed. The hospital was disbanded, and the medical attend- 
ant was left to make what arrangement he could. The 
negroes could not understand why they should not have 
the same advantage in a state of freedom they enjoyed 
during slavery. The consequence was, that in some cases 
the medical attendant was absolutely starved out ; and thus 
whole districts became destitute of any resident medical prac- 
titioner. 

To the same cause must be partly attributed the barbarity 
and cold-heartedness which has been, on so many occasions, 
shown by the negro population, on the late visitation of the 
cholera. Accustomed to have every necessary provided, and 
every want supplied, we can easily understand why an ignorant 
and semi-barbarous people should think it strange to have to ex- 
pend their time and means to provide for their suffering rela- 
tives. And hence, without sensibility or feeling, or natural 
affection, they deserted them in the time of need, stripped 
the good clothes off the perishing victim, and actually 
demanded payment for aiding to bury their own dead. 

At such a period, and under the difficulties attendant on 
the absence of medical aid, it became necessary to issue gene- 
ral directions, that the friends and neighbors might, on the 
instant, apply such relief as had been suggested by the differ- 
ent medical boards. I am fortunately able to subjoin a copy 
of these suggestions, distributed freely among the inhabitants 
in the rural districts. 

Suggestions from the Board of Health, for the Gruidance of 
the Clerical Cholera Committee. 

In cases where the bowels are simply relaxed, with yellow 
bilious motions, give one grain of opium, or twenty-five drops 



PAUL ON CHOLERA IN THE ISLAND OF JAMAICA. 205 

of laudanum, in a little ginger tea, and repeat it every hour, 
or every second hour, until the disorder is checked. 

In many instances there are severe pains or spasms of the 
bowels and stomach, without vomiting or purging. In these, 
give two grains of opium, or forty or fifty drops of laudanum 
in warm ginger tea, or hot brandy toddy, and repeat the same 
every two hours, until relieved, giving the following morning 
a full dose of castor oil, (say two tablespoonsful), and a 
dessertspoonful of spirits of turpentine, as an aperient. 

If- there be vomiting or purging, or both combined, of 
watery, rice-colored matter, with warm spine, and no appear- 
ance of collapse, give fifteen grains of calomel with three 
grains of opium, and follow it up by a similar dose in an hour 
or two, and if not relieved, give three grains calomel, one 
grain of opium, and three grains of camphor in two pills, 
every second or third hour, until the desired effect is pro- 
duced. 

If the vomiting and purging is watery with collapse, (cold- 
ness of the skin, great prostration, failure of the pulse, &c.,) 
give at once ten grains of sugar of lead, with three grains of 
opium (if no opium has been given before), and repeat three 
or five grains of sugar of lead, with half a grain of opium, 
every hour, or every second hour, according to the urgency 
of the symptoms, and until relief is obtained. 

In regard to diet, give arrow-root, sago, and the like, with 
a little brandy ; and in the collapse stage, the following mix- 
ture may be given, two tablespoonsful every half hour :- — 

Carbonate of ammonia two scruples, camphor mixture, 
eight ounces mixed, or fifteen drops of spirits of hartshorn, 
in a couple of tablespoonsful of ginger or mint tea, and repeat 
it every quarter of an hour, or twenty minutes. 

Where there are cramps of the limbs, let them be well 
rubbed with spirits of turpentine, applying dry warmth ; and 
apply to the stomach and bowels flannel wrung out of hot 
spirits of turpentine. 

For drink, cold water, barley, &c. ; water rice to be given 
freely. 



206 PAUL ON CHOLERA IN THE ISLAND OF JAMAICA. 

The above is for adults, and can be proportioned to the age 
of the patient. 

For young children, and to the age of ten, the compound 
powders of chalk with opium, as prepared by the druggist, is 
safer to use than giving proportionate doses of laudanum or 
opium. 

For an adult, ten or twenty grains, repeated several times 
a day, or after each evacuation, will be the dose; and it may 
be given to the youngest infant with safety in the dose of 
three grains, repeated according to the necessity of the case. 

(Signed) , M. D. 

November, 1850. 

From the foregoing, we may observe, 1st. That the progress 
of the epidemic was from the south-east to the north-west, dia- 
gonally across the island, diverging to the east, apparently 
having no law to guide it ; hill and valley, plain and mountain, 
river course and arid soil, being equally subject to the visita- 
tion. 

2d. That children were equally liable to the disease, as the 
more adult population. 

3d. That the great mortality raged among the colored 
population, the ratio of deaths being less in proportion 
among the merchants and others in like standing. 

4th. That in most cases, the disease appeared without any 
premonitory symptoms ; and one case occurring in a locality, 
was the forerunner of a large number being aifected, numer- 
ous deaths taking place within forty-eight hours of its first 
appearance. 

I cannot close this brief inquiry without adverting to the 
loss the medical profession has sustained, in the death of one 
of the gentlemen already named, whose professional acquire- 
ments, scientific attainments, and kindness of heart, had 
gained the respect and affection of all who became acquainted 
with him. 

Dr. James McFadyen, a graduate of Glasgow, Scotland, 
went to the Island of Jamaica about the year 1822, at the 



PAUL ON CHOLERA IN THE ISLAND OF JAMAICA. 207 

recommendation of Sir Wm. J. Hooker, to fill the office of 
Island Botanist, an office which a few years after, owing 
to the rapidly declining state of the island, was so shorn of 
its emoluments, as to induce him to resign, and he returned 
to the duties of his profession. In the meantime, however, 
he had not been idle, but collected so large a mass of infor- 
mation, that he was enabled to publish the first volume of 
his " Flora Jamaicensis." The second volume of this labori- 
ous work, I learn, was almost completed at the period of his 
death, and it is to be hoped that some kind friend, adequate to 
the task, will see it through the press, that it may not be lost 
to the public. Fully occupied with a large practice, he yet 
found time to offer contributions on medical and botanical 
subjects, several of which he read before the various societies 
in Kingston. Others were published, one of which is entitled 
a "List of Plants growing in the plain of Liguanea, St. 
Andrews" numbering 598. A note appended to the list, 
states, " The plain of Liguanea I consider as extending from 
the Ferry to Rock Fort, bounded towards the north by the 
base of the mountains, and towards the south by the sea, 
The vegetation of the upper part of the plain, which is fre- 
quently visited by showers from the hills, is very different 
from the dry parched fields and thickets of the neighborhood 
of Halfway Tree ; and this again differs considerably from 
what is observed along the sea coast, on which stands the city 
of Kingston." 

The only apology I shall make for detaining you with this 
short extract is, because, in my opinion, the example is an 
excellent one to be followed. By confining the researches to 
an area of a few miles at a time, a much more minute and 
accurate knowledge of the botany of a locality can be 
obtained, than when extended over a larger and more exten- 
sive surface. 

I shall close these observations with the hope, that although 
they allude to a country foreign to our own, yet the subject 
is not without interest to those who wish to add to their gene- 
ral information, and the knowledge of disease, and of the 
human race, in other lands. 



208 PATTERSON ON POISONED WOUNDS. 

Poisoned Wounds. — By Geo. W. Patterson, M. D., Resi- 
dent Physician of the Northern Dispensary. 

A variety of this class of wounds I occasionally see at 
the institution with which I am connected, a notice of which 
I have thought might be interesting to your readers. 

The disease is known to those who are subject to it, as 
" bone fever" so called, I suppose, because it is not an un- 
usual occurrence to workers in bone. 

It usually happens in the following manner. In order to 
soften the bones preparatory to turning them, it is customary 
to macerate them in water. This, although not allowed to 
stand for a long time, soon becomes quite putrescent. If the 
hands of those employed be now placed in this fluid, while 
there are any wounds or abrasions upon them (and they are 
very liable to such accidents), the disease under consideration 
is soon developed. 

I have never seen it at an early period, having usually, when 
it came under my notice, extended from the extremity of one 
or more fingers up the hand, in the form of erysipelatous in- 
flammation, this extending to the other fingers in succession, 
and disappearing from them in the order in which they were 
attacked, though adhering with pertinacity to the finger pri- 
marily affected. In no instance did the inflammation eventu- 
ate in suppuration. Red lines were perceptible about the 
wrist and forearm, indicating inflammation of the absorbents. 

It is attended from the first with intense throbbing pain, 
and as it advances, more or less febrile excitement is developed. 
This severe affection, occurring generally to persons who are 
entirely dependent upon their daily labor for support, detain- 
ing them frequently a long time from their employment, is to 
them a grievous affliction. 

When seen early, it would appear reasonable to suppose 
that cauterization of the wound with nitrate of silver, would 
arrest its course. In my first case, where it was applied to 
the wound, it did not seem to be of any service ; the disease, 



PATTERSON ON POISONED WOUNDS. 209 

however, had advanced to some extent previous to the appli- 
cation ; at the same time cooling lotions were applied and a 
cathartic of sulphate of magnesia, with a nauseating dose of 
ant : et pot : tartras, was administered. The remedies employed 
not acting very promptly in the removal of the disease, the 
patient without my direction, applied lye poultices, to which 
apparently the disease soon yielded. Being disposed to give 
this application some credit, I concluded I would use a sol: 
of carb : of potash in the next case of the kind I should be 
called upon to treat. I accordingly did so, and have since 
had six cases, and found the following lotion, applied warm, 
an efficient application.* 

R. — Potass, carbonat: ^ss; 
Tinct. opii, f ^j ; 
Aqua, Oj.— M. 

Whether the nitrate of silver would have acted more bene- 
ficially in the case alluded to, had it been applied to the 
wound sooner, or subsequently to the whole of the inflamed 
surface, I am not prepared to say, though I am aware that 
the latter practice has been recommended in erysipelatous 
inflammation. 

In regard to the application of caustic to poisoned wounds, 
Sir A. Cooper says, "An opinion is entertained by many 
that the symptoms after injuries in dissection do not depend 
upon the absorption of putrid matter, but on the constitution 
of the injured person, wherefore they reject all escharotics. 
Whether this opinion be well founded or not, I however agree 
with them in regard to the application of caustic, as thereby 
irritation and inflammation of the wound with its conse- 
quences, which otherwise would not have happened, would be 
only too easily produced." 

There appearing to be some analogy between the poisoned 
wounds under consideration and wounds received in dissection, 
it would seem from the authority I have quoted, that no 

* When used in conjunction with the general treatment before men- 
tioned. 



210 ALLOPATHY, A MISNOMER, BY J. H. STUART. 

benefit could be expected from caustic applications in such 
cases. In the present instances, however, the alkaline solu- 
tion was certainly beneficial, and I consider it preferable to lye, 
inasmuch as a preparation of known strength is thus furnished, 
the homely application which is so frequently resorted to being 
of variable power, and sometimes causing troublesome ulcera- 
tions. I have seen such results repeatedly. 
Philadelphia, March 13, 1851. 



Allopathy, a Misnomer. By James H. Stuart, M. D. 

I select the columns of your journal for my present 
communication, principally because it is edited in a State 
which has shown, and is showing, a most zealous determina- 
tion to purify our noble profession from the stains which all 
must admit are beginning to fall upon it. 

The subject I would call attention to at present, is one 
which merits more attention than is usually paid to it by 
educated physicians. I allude to the careless adoption of 
popular terms by medical men, which, however slight the evil 
of any individual instance, is productive in the aggregate, of 
vast harm. 

One word alone will serve my purpose, as an illustration. 
The word "Allopathy." This is in very frequent use, even 
among physicians, and, as you well know, Mr. Editor, it is, as 
applied to the regular practice of medicine, a gross misnomer. 
When physicians use it they grant to Homoeopathists, Hydro- 
pathists and other quack "pathists" all they ask, viz., a 
tacit acknowledgment that we are practising on but one of 
several systems of medicine while they practise on the others ; 
than which nothing can be more absurd. For, the derivation 
(from alios another, and pathos suffering) implies that con- 
trary to the infinitesimals, we cure by remedies of an oppo- 
site character to the manifestations of disease, whereas they 



CHOLERA, A MISNOMER, BY G. H. DOANE. 211 

use " like medicines." This is, of course, an absurdity; for 
the regular physician has, since Hippocrates, practised on 
an eminently eclectic system, disdaining nothing which would 
conduce to the desired end, whether strychnia and veratria, 
or chalk, and bread pills. 

The evil of yielding to quacks by adopting the titles they 
choose to saddle us with, by condescending to appear as the 
opposites of any quackery, is immense. 

The regular practice of medicine has marched steadily and 
proudly on from the remotest antiquity, increasing certainly 
in strength and usefulness, totally regardless of the various 
quacks and nostrums which have risen, flourished during 
their ephemeral existence, and faded in obscurity around it. 
And shall we now condescend to name our loved science by a 
title even remotely allied to quackery ? 

It is degrading in any regular physician to descend from 
his high eminence and adopt a term invented by quacks to 
undermine the dignity of our profession. I could say much 
more on this subject, but I grow indignant in contemplating 
such knavish impudence, and feel that all must perceive the 
necessity of retaining our self respect. 

Erie, Pa., March 8, 1851. 



Cholera, a Misnomer. By Geo. H. Doane, Student of 

Medicine. 

The aim and object of science is indubitably the classifica- 
tion of knowledge ; and it is because the experience of former 
ages in the practice of medicine has become classified in our 
own, that we often hear the elevation of medicine to a 
science spoken of as one of the advances of the nineteenth, 
upon former centuries. To this most desirable end the an- 
tiquity of its resources has often proved a serious obstacle. 
For instance, although many of the old diagnoses of diseases 



212 CHOLERA, A MISNOMER, BY a. H. DOANE. 

have been found erroneous, the names are still retained, which 
sprang from them. Therefore, in an attempt to classify such, 
the nomenclature would point to one compartment, while the 
real nature of the disease would point to another. It should 
be the business of all who desire to see the good work prose- 
cuted which has been so well begun, to detect and disclose 
all instances of this nature which may occur to them. 

The recent prevalence of the so-called "Cholera Asiatica,'' 
in our country, made me notice more particularly the dis- 
cordance between the treatment of it, as founded upon the 
nature of the disease, and that which the name would lead us 
to employ. While the name would say, " The flow of bile is 
to be arrested,'' the state of the case would say, "The 
liver is torpid, and to the re-appearance of its secretions 
should all our efforts be directed." Thus, the name would 
forbid us to use the medicine which all testimony concurs in 
recommending as the only reliable remedy, viz., calomel. 

Again, no one denies the inapplicability of the present 
name, and to avoid this contradiction in terms, let us adopt 
as a substitute (provided a better one does not offer) the name 
"Orrhoea." Its derivation (from 6po$ serum, or water of the 
blood, and p £W to flow) perfectly describes the disease. 

Among other advantages resulting from such a name as 
this, the abstemious diet which was so much in vogue during 
the prevalence of the disease, and which unquestionably was 
one of the great causes of its mortality, would be avoided. 
It would be plain to all, that a well-nourished body would be 
far more capable of resisting the attacks of this malady, than 
one laid open to its inroads by the deteriorated state of the 
system. Thus the disease and its representative name would 
agree in the compartment of nosology, to which it should be 
consigned. 

Burlington, April 16, 1851. 



MINUTES OF BURLINGTON CO. DIST. MED. SOCIETY. 213 

Extracts from the Minutes of the Annual Meeting of the 
Dist. Med. Society for the County of Burlington, held 
at Mount Holly, April 15th, 1851. 

The President, Dr. Budd, in the Chair. Present twelve 
members. 

The minutes of the last meeting were read, corrected, and 
adopted, and directed to be recorded. 

Dr. Young, of Bordentown, Dr. S. W. Butler, of Burling- 
ton, and Dr. B. H. Page, of Columbus, were unanimously 
elected members, when, being present, they paid the initia- 
tion fee, signed the constitution, and took their seats in the 
society. 

Dr. Woolston called the attention of the society to a letter 
received by himself, from Dr. Stanley, of London, in refer- 
ence to the splint invented by Dr. W., for the treatment of 
fractures of the femur, which, on motion, was read. 

On motion, it was Resolved, That this society recommend 
to the notice of physicians and surgeons, the splint invented 
by Dr. Woolston, for the treatment of fractures of the femur, 
as having merits claiming the attention of the profession in 
general. 

The Secretary is directed to furnish Dr. Woolston with a 
copy of this resolution, signed by the President and Secre- 
tary. 

The society then went into an election of officers for the 
ensuing year, when Dr. H. H. Longstreet was unanimously 
chosen President ; Dr. I. P. Coleman, Vice-President ; Dr. 
B. H. Stratton, Treasurer ; Dr. F. Gauntt, Corresponding 
Secretary, and Dr. Job Haines, Recording Secretary. 

Drs. Job Haines, I. P. Coleman, S. Woolston, and George 
Haines, were chosen delegates to represent this society in the 
State Medical Society the ensuing year, with power to fill 
vacancies. 

After the report of the committee upon the finances of the 
society, the President read a paper upon uterine hemor- 
vol. iv. — 19 



214 AMPUTATION WITHOUT SUPPURATION. 

rhage, giving the history of some cases, together with remarks 
upon the use of the tampon. After considerable discussion 
upon the treatment and remarks from the members, a vote of 
thanks of the society was given to the President for the 
address, when the society adjourned, to meet on the third 
Tuesday of October next. 

JOB HAINES, 

Secretary. 



Case of Amputation not followed by Suppuration. — In a 

private letter from a medical friend in Boston, Mass., the 

following singular case is adverted to. Speaking of a late 

amputation at one of the public institutions in that city, in 

which the arm was taken off just below the elbow, he says, 

" I will mention in connection with this case, what is very ^remarka- 
ble. Since the closing of the flaps, there has been no tumefaction, no 
inflammation of the stump, and consequently no suppuration, except a 
drop or two around the ligatures, which have not yet come away, though 
this is the fifth week since the operation. This perfect union by the 
first intention, is the more astonishing because the subject is scrofulous, 
and was not in a very favorable condition. The arm was removed on 
account of a scrofulous affection of the wrist. Several of the tissues 
were invaded, and the patient suffered greatly from pain in the hand." 

* 



BIBLIOGRAPHICAL NOTICES. 



On Diseases of Menstruation and Ovarian Inflammation 
in Connection with Sterility ', Pelvic Tumors, and Affections 
of the Womb. By Edward John Tilt, M. D., Physician 
to the Farringdon General Dispensary, and to the Padding- 
ton Free Dispensary, for the Diseases of Women and Chil- 
dren. " Omne animal ab ovo." New York, Samuel S. 
and William Wood, No. 261 Pearl St., 1851. ' 

We have just received from the publishers a copy of " Tilt 
on Menstruation" pp. 286; and though we have not had an 
opportunity to read it carefully, we find it to contain much 
that has not hitherto been collated on the diseases of the 
female generative systems. The author says in his preface, 

"I can lay claim unfortunately to no discoveries; but from 
an acquaintance with the literature of that branch of the 
profession to which I have devoted my chief attention, I feel 
justified in affirming that in no other work will the reader 
find so complete an account of the various ways in which 
sterility is produced by the action of inflammation on the 
ovarian tissues, of the great importance of ovarian peritonitis 
as a cause of disordered menstruation, or of the influence of 
ovarian inflammation in the production of uterine disease — 
facts forcibly exemplified, and proved to be not mere con- 
ventional possibilities, but events of frequent occurrence." 

Dr. Tilt assumes that the uncertainty of medicine, and the 
want of success in medical practice, is owing to a want of 
precision in medical language — our terms being too general 
to indicate special diseases. Hence the nosology of uterine 
diseases as at present acknowledged under the terms amenor- 
rhoea, dysmenorrhoea, leucorrhoea, and menorrhagia, are dis- 
carded by the author, as having no definite meaning. The 
indications by which we recognize them depend upon such a 



216 BIBLIOGRAPHICAL NOTICES. 

variety of causes, that they should no longer be considered 
as substantive terms ; each name signifying too many condi- 
tions to be represented by a single term. The uterus is not 
considered the principal organ of generation, being subser- 
vient to the ovaries, and holding the same relation to these 
bodies that the bladder does to the kidneys. It is therefore 
thought that the diseases which we are in the habit of calling 
uterine, and the great variety of sympathies resulting there- 
from, are justly attributable to the ovaries : that they are the 
result of sub-acute ovaritis, and should be called ovarian. 

Time will not admit of a much more extended notice of 
this interesting volume; but we find in the concluding chap- 
ter, that the author makes a few practical deductions from 
what he has stated in the body of his book, which will sig- 
nify to the reader the idea which seems to give character 
to his investigations in this interesting department of medi- 
cal science. The diseases of menstruation are mainly attri- 
buted to ovarian inflammation, or of structural lesion of the 
ovaries, while organic lesions of the neck of the womb are 
said to be induced by the same causes. Hysteria also is 
traced to subacute ovaritis, by inducing a reflex action of 
the cerebro-spinal nerves. The suppression of the menstrual 
flow is also traced to the same ovarian origin, inducing uterine 
engorgement. Painful menstruation is accounted for as a 
symptom of ovarian peritonitis, or of morbid ovulation, the 
pain being induced by an effusion of the menstrual secretion 
into the peritoneum, in consequence of a partial closure of 
the neck of the uterus. 

We think the profession cannot fail to be interested by a 
perusal of Dr. Tilt's observations ; and we would recommend 
them to obtain it. We ought to mention that much of the 
work is occupied with the history of cases, treatment, &c, 
from which much that is valuable may be obtained. 

We would take this opportunity to remind the publishers, 
that had the work been sent through our agent in New York, 
whose address will be found on the cover of the " Reporter," 
it would have been received much earlier. We suppose it has 
been some weeks in reaching us. 



BIBLIOGRAPHICAL NOTICES. 217 



The U. S. Pharmacopoeia f 07' 1851, revised and improved 
by the National Convention, lies on our table, and a notice 
of it will be prepared by a pharmaceutical friend for our next 
number. 



Medical Delusions, by Worthington Hooker, M. D., is 
also waiting for and deserves a notice, but we cannot say more 
now than that it is equally worthy of regard as his late work 
entitled u Physician and Patient." 



Cases of Vesico- Vaginal Fistula, treated by Operation, 
by Geo. Hayward, M. D., of Boston, is the title of a pam- 
phlet of twenty-one pages, which has been received within a 
few days. It describes nine cases successfully treated by Dr. 
Hayward. In three cases the operation was entirely success- 
ful ; in five the patients obtained great relief, so that the 
urine could be retained for a number of hours, without any 
escape through the fistulous opening ; and in the remaining 
two, no benefit was derived from it. The method of operat- 
ing is to close the fissure by ligature, and draw the urine by 
a catheter till cicatrization takes place. 



Just in time to notice on this blank space of our proof- 
sheet, we have received a pamphlet entitled " The Present 
Tendency of Investigation in Medicine, ,y an Address, by Dr. 
Samuel Parkman, of Boston, before the Suffolk District 
Medical Society, at its Second Anniversary Meeting, March 
28, 1851. 



EDITORIAL. 



THE MEDICAL LAW. 

Our readers will find in the Eclectic Department, the sup- 
plement to the medical law, passed by our last legislature. 
Its provisions materially modify the old act of 1830. While 
it relieves graduates of medical schools, which are, or may 
be recognized by the medical society, from the penalty im- 
posed upon illegal practitioners, it leaves no room for com- 
plaint on the part of the people, that they cannot discrimi- 
nate between those who have been trained in schools of 
acknowledged merit, and those which have grown up like 
mushrooms, to spread their poisonous shadow for a season, 
and beguile the unwary into a dependence upon false theories 
and dangerous practice, for the mere purpose of personal 
aggrandizement, by promises which are seldom realized, and 
which no honorable and well-informed physicians would ever 
make. 

We would rejoice to see the newspaper press of New Jersey 
take the ground upon this subject that has been assumed by 
the "Sentinel of Freedom^ of Newark, from which jour- 
nal we subjoin the following extract of an editorial article 
on the importance of legal restraints, upon entering the pro- 
fessions of medicine and law. 

" There was a time, when wholesome restraints upon license, which 
some persons call liberty, were thought to be useful checks against 
fraud and deception. The general enthusiasm for civil and political 
freedom has changed all this, and made the least restraint upon per- 
sonal action in the highest degree unpopular. It is a wonder that any 
traces of it at all are left. There are, however, some. One, for exam- 
ple, is the requisition, that the owner of a steamboat shall procure and 
publish a certificate of the soundness of his apparatus at stated periods. 
People are even yet very much dissatisfied that other and more strin- 
gent restrictions are not imposed on men who deal in steamboats. 



EDITORIAL. 219 

Does not the public run a greater hazard every day, sometimes in re- 
spect to life, sometimes in relation to their property or reputation, in 
coming into connection with practitioners at the bar, or members of the 
medical profession? Certainly, the risk incurred, by being put in the 
power of these, in life, estate, and fame, is quite as great as traveling 
in steamboats ; and the loss and suffering quite as hard to be foreseen, 
or be avoided. It requires as much sagacity, every one must allow, to dis- 
tinguish between a good and bad physician, as to tell a sound steam- 
boat from a rotten one. 

"It cannot be denied that the less favored portion of mankind need 
some help to save them from being made the prey of the unprincipled 
and designing. The qualifications required of men for the privilege of 
exercising certain callings, ought to be viewed, as they are evidently 
intended, as restrictions, not privileges ; and designed as safeguards 
for the rest of the world. Somehow or other, instead of this obvious 
view, the reverse aspect has been so adroitly presented, and somebody 
has had the ingenuity to persuade the public that they have, as a body, 
a greater interest in extending the facilities of getting into a profession, 
than they have in increasing the securities that the professions at large 
shall discharge their responsible offices with integrity and talent. The 
very statement of the matter proves, at a glance, that the principal 
concern of the mass of the public is, that there should be some evidence 
presented somewhere, and to somebody who is qualified to judge of 
such abstruse and difficult matters, as the qualifications of the practi- 
tioners of law and medicine, so that they who are not able to form any 
opinion, of themselves, shall not be imposed on by their inability to 
tell a man of real knowledge from a dishonest pretender. There is a 
great embarrassment now in the minds of the majority of the commu- 
nity on those points, where they have no particular means of informa- 
tion; and thousands of strangers, especially in cities, are just as likely 
to place their property, or their lives, in the hands of miserable charla- 
tans, as of honorable men. 

" It is perfectly ridiculous to suppose that there is, when compared 
with the mass of the community, any number of men worth mention- 
ing, who are anxious to embrace either of the professions. It is not 
their wish or advantage, therefore, which is to be consulted, but that of 
the great balance of the people, which deserves the care and parental 
consideration of the Legislature. It is they, who are every moment in 
imminent danger of imposition, and know not how to avoid it, for whose 
protection barriers should be erected. Especially should none now ex- 
isting be abolished, under the hollow pretence that such an act will be 
the destruction of the privileges of a few; when, in reality, those very 
requisitions, falsely called privileges, are the invaluable securities of the 
public against ignorant pretension, empiricism, and fraud." 

It is a mortifying fact, that though editors and publishers 
are well paid by quacks and impostors, they are so generally 
willing to make their papers the instrument by which the 
thoughtless are deceived, the ignorant cheated, the sick and 
suffering made more miserable, and the confidence of the 
public lessened in the usefulness of scientific research, and 
the necessity of laborious study, to acquire a knowledge of 



220 EDITORIAL. 

the human system, both in its healthy and diseased conditions, 
with all the collateral acquirements that are essential to the 
wise administration of remedial measures, in the hour of sick- 
ness and pain. We hold it also to be an incontrovertible 
truth, that all advertisements for quack medicines, all certifi- 
cates of wonderful cures, all recommendations for secret 
remedies, and the like, with which the columns of our public 
papers are crowded, have a demoralizing tendency upon the 
public mind, because they deceive the people by promising 
what is never accomplished, and have no foundation in science 
or truth. The profession of medicine is an honorable pro- 
fession ; it has no secrets, it asks for no certificates, it seeks 
no editorial flattery, or newspaper recommendations; it de- 
pends not upon the popular cry; its attributes are humanity 
and love; its aim, to relieve suffering, and if possible, to 
save life. And while we do not entirely approve some of the 
modifications made by the legislature in our charter, we be- 
lieve it has met the issue, which has been pressed upon it by 
petitioners to abolish all restrictions upon this subject with a 
commendable regard for the public good, and desire to protect 
the uninformed from the injurious tendency of the various 
forms of empiricism which are rife in the community. 

American Medical Association. ,- — This Association meets 
in Charleston, South Carolina, during the present month, 

The delegates appointed by the New Jersey State Medical 
Society are Drs. G. R. Chetwood, of Elizabethtown, and I. 
S. Mulford of Camden, and Drs. S. H. Pennington, of New- 
ark, and A. D. Woodruff of Haddonfield, alternates. 

TO CORRESPONDENTS. 

We are indebted to the correspondents of the u Reporter ;" 
for their prompt attention to our suggestions, and would re- 
turn our thanks therefor. To Dr. Paul we feel especially 
obliged for the pains he has recently taken to add to the 
value and interest of our journal, by furnishing us with his 
several valuable papers. 



EDITORIAL. 221 

EXCHANGES, ETC. 

The March number of the Charleston Medical Journal 
has not come to hand. Will the editor oblige us by forward- 
ing it? 

Why do we not receive the Western Journal of Medicine 
and Surgery and the North Western Medical and Surgical 
Journal? We would be glad to receive those journals regu- 
larly. 

The Northern Lancet begins its third volume in a new 
form and very much improved in typographical appearance., 
which we do hope will be kept up, as it was formerly almost 
illegible. We hope the editors will not sacrifice real worth 
to cheapness. 

The Western Lancet always comes to us in dishabille, con- 
sequently it is very apt to be laid aside in looking over our 
budget, to avoid the trouble of trimming the leaves. This is 
the only fault we have to find with that excellent journal. 

The following miscellaneous pamphlets have been received. 

An Address delivered before the Erie County Medical So- 
ciety. By Rev. William Flint, M. D. This highly interest- 
ing address contains a brief history of medical delusions, and 
is worthy of extensive perusal, both in and out of the profes- 
sion. 

Proceedings of the Medical Association of the State of 
Alabama, held in Mobile, Dec. 1850. 

Success in the Medical Profession, an Introductory Lec- 
ture, by John Ware, M. D., of Boston. 

Comparative Intellectual Standing of the Medical Profes- 
sion, an Introductory Address to the Class of the Medical 
School of Maine. By E. R. Peaslee, A.M., M. D. 

Charge to the Graduates of Jefferson Medical College, 
Phila. By Thos. D. Mutter, M. D., March, 1851. 

By-Laws, fyc. of the Pennsylvania State Lunatic Asylum. 

Eighth Annual Report of the N. Y. State Lunatic Asylum. 

Thermal Ventilation, and other Sanitary Improvements, $c. 
Discourse delivered at the New York Hospital, by John Wat- 
son, M. D. 



ECLECTIC DEPARTMENT. 



A Supplement to an Act entitled "An Act to Incorporate 
Medical Societies, for the purpose of regulating the Prac- 
tice of Physic and Surgery in this State" passed January 
28, 1830. 

1. Be it Enacted by the Senate and General Assembly of 
the State of New Jersey, That the annual meetings of the 
Medical Society of New Jersey shall be held yearly and 
every year, in the city of Trenton, on the fourth Tuesday of 
January; and that the said society be and is hereby author- 
ized and empowered to dispense with its semi-annual meet- 
ings. 

2. And be it Enacted, That it shall be lawful for any per- 
son of good moral character, who has obtained a diploma for 
the degree of Doctor of Medicine and Surgery, from the 
College of Physicians and Surgeons in the city of New 
York, the Medical Department of the University of the city 
of New York; the Medical Department of the University of 
Pennsylvania ; Jefferson Medical College, and the Medical 
Department of Pennsylvania College, in the city of Philadel- 
phia, or such other Medical College or University as the Medi- 
cal Society shall from time to time designate, to present such 
diploma to the President of the Medical Society of New 
Jersey, together with the testimonials of his good moral cha- 
racter ; and the President of said Society shall thereupon, if 
satisfied with such testimonials, be authorized and empowered 
to grant a license under his hand and seal of the Society, to 
the person named and intended in said diploma, to practice 
physic and surgery in the State of New Jersey; for which 
the said President shall be authorized to demand from the 
person so licensed a sum not exceeding five dollars, to be 



ECLECTIC DEPARTMENT. 228 

appropriated in such manner as the members of the said 
Society shall order and direct. 

3. And be it Unacted, That the penalty and disqualification, 
specified in the twelfth section of the act to which this is a 
supplement, shall not be held to apply to any person who, 
without having passed an examination by the censors, has re- 
ceived a license from the President of the Medical Society of 
New Jersey, agreeably to the second section of this act. 

4. And be it Enacted, That it shall be lawful for the Medi- 
cal Society of New Jersey, to require the censors appointed 
under the eighth section of the act to which this is a supple- 
ment, in addition to the subjects specified in the said section, 
to examine the applicant or applicants for license, not having 
obtained a diploma in the arts, from some college or univer- 
sity, on such branches of general science and learning as the 
said Medical Society shall from time to time designate. 

5. And be it Unacted, That it shall be lawful for the 
Medical Society of New Jersey to direct its board of censors 
to demand from every applicant for examination, not having 
obtained a diploma in the arts, satisfactory evidence that he 
has employed one of the four years of study required in the 
ninth section of the act, to which this act is a supplement, in 
the study of such branches of general science and learning, 
as may have been designated by the said Medical Society, 
agreeably to the fourth section of this act. 

6. And be it Enacted, That the tenth section of the act to 
which this act is a supplement, be and the same is hereby re- 
pealed. 

7. And be it Enacted, That it shall be lawful for the 
Medical Society of New Jersey, on application by any Dis- 
trict Medical Society, legally organized, in this State, to re- 
voke the license of any person who shall have obtained the 
same through fraud or in violation of any of the requirements 
of this act, or the act to which this is a supplement, or who 
has dishonored himself by disgraceful conduct or gross mal- 
practice ; Provided, that the person so charged shall have 
had full opportunity of defence, and two-thirds of the mem- 



224 ECLECTIC DEPARTMENT. 

bers of the Medical Society of New Jersey, present at an 
annual meeting of said society, shall, by ballot, sustain the 
charge. 

8. And he it Enacted, That the whole amount of penalty 
in any instance incurred, under the twelfth and fourteenth 
sections of the act to which this act is a supplement, shall be 
paid into the treasury of the city or township in which the 
offender resides, for the benefit of the poor. 

9. And he it Enacted, That all such parts of the act to 
which this is a supplement, as conflict with the provisions of 
this act, be, and the same are hereby repealed. 

Approved, March 14, 1851. 

Morphine in Strangulated Hernia. — Dr. A. B. Shipman, 
of Syracuse, N. Y., speaks in terms of the highest commen- 
dation of this remedy, as being speedy, safe, and satisfactory 
in its operation. It has been employed with marked success 
by himself and some of his medical friends for several years, 
never failing when given in full doses, unless extensive adhe- 
sions have taken place, rendering reduction impossible with- 
out resorting to an operation. He believes that " there is 
scarcely a case of recent strangulation which may not be 
speedily and easily reduced by a judicious use of large doses 
of morphine.'' Its modus operandi is by allaying spasm 
and relaxing the muscles, thus allowing the spontaneous re- 
duction of the hernia, especially if the position of the patient 
is favorable. It also prevents the recurrence of effusion, by 
allaying irritation, thus preventing inflammation from de- 
veloping itself, as it would do if anodynes were not exhibited. 
Dr. S. does not present this as a novel mode of treatment, 
but desires to call the attention of the profession more parti- 
cularly to it, thinking it applicable to a greater extent than 
has hitherto been supposed. — Boston Medical and Surgical 
Journal. * 

Eruptions of the Shin during Pregnancy. — In a commu- 
nication read at a quarterly meeting of the Rhode Island 



ECLECTIC DEPARTMENT. 



225 



Medical Society, Dr. Hiram Allen related two cases of 
eruptions on the skin, accompanied by excessive itching, 
occurring during pregnancy, in each of which the patient 
was afterwards delivered of a dead foetus, in a state of partial 
decomposition, having apparently been dead for several 
weeks. 

Dr. A. views this in the light of cause and effect, consider- 
ing the disease of the surface as "the effect of Nature's de- 
purating process, to rid the system of intra-uterine poison 
which had been absorbed." — Ibid. 



* 



Consultations.- — Dr. Ware, of Boston, in his a Success in 
the Medical Profession" says, "There is no way in which a 
patient is so likely to derive all possible aid from our art, in 
a case involving great anxiety and danger, as when he is 
under the combined care of an old and young physician, and 
has all the advantage of the observation and vigilance of the 
one, and of the experience and wisdom of the other." * 

List of Colleges, Classes, and Q-raduates for 1851, so far as 



heard from 


.* 








Class. 


Graduates. 


Proportion 

of Grad's 

to Class. 


University of Pennsylvania, 


466 


167 one in 2.79 


" New York, 


411 


116 < 


' 3.54 


" Virginia, 


93 


24 < 


< 3.87 


" Maryland, 




45 < 




" Iowa, 




10 < 




" Missouri, 




83 < 




" Buffalo, 


115 


30 < 


< 3.83 


Washington University of Baltimore, 


13 < 




Harvard University, 




10 < 




Jefferson Medical College, 


504 


227 < 


< 2.22 


N. Y. Coll. of Phys. and Surg's., 


230 


56 < 


< 4.10 


N. Y. Medical College, 


40 


12 < 


< 3.33 



* For a part of this list we are indebted to the New York Medical 
Gazette. 



226 ECLECTIC DEPARTMENT. 

Class. Graduates. Proportion. 

Pennsylvania Medical College, 36 one in 

Phila. Coll. of Med. (2 sessions), 244 72 " 3.38 

Western Reserve College, 202 " 

Starling Medical College, 125 35 " 3.57 

Castleton Med. Coll. (2 sessions), 153 64 " 2.39 

Yale College, 38 11 " 3.45 

Geneva Medical Institution, 101 " 

Albany Medical College, 93 " 

Medical College of Georgia, 159 50 " 3.18 

Richmond Medical College, 26 " 

Ohio Medical College, 180 59 " 3.05 

Louisiana Medical College, 37 " 

Medical School of Maine, 51 " 

Anaesthetic Action, (L'Institut, No. 886.) — M. Aran has made ex- 
periments on the anaesthetic action of certain agents used as an ex- 
ternal application to the skin, and has found that the best material for 
this purpose is chlorated chlorohydric ether. The sesquichloride of 
carbon may also be used, but whilst the ether operates effectually in a 
few minutes, at least two hours are required to produce insensibility 
with the sesquichloride. To produce the desired effect, from 15 to 30 
drops of the pure chlorated chlorohydric ether suffice ; they are put 
upon the part in pain, or upon a piece of linen cloth which is to be 
immediately applied to this part, and the contact is maintained by a 
bandage ; and quickly the pain is relieved. A pomatum of this ether 
may aloo be employed, consisting of 4 grammes to 20 of suet; or if of 
the sesquichloride of carbon, 4 of this agent to 30 of suet; it may be 
used either with friction or without. The insensibility is not simply 
cutaneous, for it gradually extends to the parts beneath. 

The chlorated hydrochloric ether is obtained by the action of chlorine 
on hydrochloric ether, by which compounds containing chlorine in 
increasing proportions are formed, isomerous with the series of bicar- 
burets of hydrogen, and identical with the same series in the density of 
the vapor for corresponding compounds. It is a colorless liquid, of an 
ethereal aromatic odor analogous to chloroform, and a sweetish and 
even peppery taste at times ; hardly soluble in water, but wholly so in 
alcohol, sulphuric ether, and most of the fixed and volatile oils. It is 
without action upon paper of tournsol; is not inflammable; has a vari- 
able density and a variable point of ebullition, oscillating between 
110° and 130° C, showing that the material is rather a mixture of 
several ethers than a single simple substance. All the chlorated chlo- 
rohydric ethers have the same anaesthetic properties, and they cannot 
be separated completely from one another. — Am. Journ. of Science and 
Arts. 

Cod-Liver Oil in Diseases of the Eye. Wills' Hospital Reports. By 
A. F. Macintyre, M. D. — This remedy was employed in the constitu- 
tional treatment of all the various forms of scrofulous ophthalmia, and 



ECLECTIC DEPARTMENT. 227 

the results were such as fully to sustain the great confidence which Dr. 
Hays has in its efficacy, a confidence which, he remarked, had been 
gained from the use of the cod-liver oil in a large number of cases in 
both public and private practice for the last three years. The oil was 
also found of especial value in all cases which, under ordinary treat- 
ment, have a tendency to frequent relapses ; in these cases, its use alone 
was found sufficient to effect a cure, unaided by local applications. This 
was most evidently manifested in the case of a sailor, set. 25, who came 
into the hospital in March last, and for the last three years has been 
the subject of a most intractable conjunctivitis. Up to the 1st of No- 
vember last, the usual modes of treatment were diligently employed 
without any amendment ; indeed, he was much worse in October than 
he had been at any time since he came into the hospital. From the 
time of his admission up to the 1st of November, he had several very 
severe relapses, in the last of which he had an ulceration of the cornea, 
which perforated and allowed the escape of the aqueous humor. It 
was while suffering the most in this relapse that he was ordered the 
cod-liver oil, with an entire discontinuance of all other remedial means. 
At that time the vascularity of the cornea was such as entirely to ob- 
scure vision — lachrymation was profuse, and photophobia intense ; his 
improvement from that time to this (January 24, 1851) has been rapid 
and permanent. He can now see to read ; he can also bear the light 
of noonday without lachrymation or inconvenience of any kind, and 
the great vascularity of the cornea has almost entirely subsided. Many 
other instances, illustrative of the statements above made, might be 
cited from the present service of Dr. Hays, did the space designed to be 
occupied by this report permit. — Am. Joum. of Med. Science. 

External Application of Diuretics in Dropsy. — As external medication 
is now beiug made the topic of much discussion in the medical journals, 
it is important that its results in private practice should be made known. 
Our pages are ever open for practical contributions upon this subject, 
and we invite all who have made use of external medication in dropsies, 
to write out the results for the Journal. We have tried the remedy in 
one case, which was perfectly successful. A lady, aged 45 years, had 
for some months an increasing quantity of fluid accumulating in the 
abdominal cavity, which so distended it, that at the time of our first 
visit she was suffering greatly from the pressure. The quantity of urine 
evacuated, as is usual in such cases, was very scanty. After using the 
common remedies without much benefit, we were induced to try the 
effect of external medication, which it affords us much gratification to 
say was attended with the happiest results. Our formula was as fol- 
lows: — R. Tr. digitalis, tr. scillse, tr. saponis et opii, aa §ij.; aqua am- 
nionic, oleum camphorse aa^ss. ; tr. can tharides fort. gij. M. This 
was rubbed freely into the skin three times a-day. It only required 
three times the quantity above mentioned to be used, before our patient 
was well. It is now four months since her recovery, and there has 
been no return of the disease ; our patient is in the enjoyment of even 
better health than she has experienced for many years before. It might 
not be as effectual a remedy in every case ; but we are inclined to be- 
lieve, if there be no organic disease, in most cases the same results 
would follow. At any rate, it is worthy of repeated trials. — Boston 
Med. and Surg. Joum. 

Prophylactic Treatment of Puerperal Fever. — Dr. J. P. Mettauer, of 
Virginia, valuable communications from whom have formerly at differ- 



228 ECLECTIC DEPARTMENT. 

ent times been communicated to this Journal, describes, in the Charles- 
ton Medical Journal, a prophylactic course of treatment adopted by 
him in puerperal cases. He speaks first of " purging in a few hours 
after delivery," by the following cathartic: — R. Aloes socot., gr. vij.; 
scam, alep., gr. v.; calomel, gr. viij.; ipecacuanha, gr. j.; water, q. s. 
Make the mass into four or five pills for a dose. 2d. "Purging more 
remotely after delivery," by the following — R. Aloes socot., jalap rad. 
pulv. aa gr. viij.; colocynth. pulv., gr. iij.; water, q. s. Make into 
three or four pills. From one to three to be taken at a time. Or, R. 
Aloes socot., gr. ij.; jalap pulv., gr. iij.; rhei pulv., gr. iv. ; ipecacu- 
anha, gr. j. ; water, q. s. Make two or three for one dose. 3d. "Purg- 
ing in all cases after delivery." Under this head he remarks — 

" This has been my custom for many years, believing that women are 
more or less predisposed to puerperal peritonitis and fever, in every 
case after parturition. In twelve hours after delivery I invariably 
order a cathartic, mild or otherwise, no matter how favorably situated 
the case may be ; and I believe that many cases, nay, I might with pro- 
priety say all, have been benefited by the practice more or less. I think 
it very probable that attacks of fever have been warded off by it, when 
a predisposition to the disease was not suspected. Certainly the prac- 
tice greatly ameliorates the condition of the breasts during the setting 
in and early periods of lactation. It also guards patients against cer- 
tain cutaneous and other irritations frequently consequent upon partu- 
rition. I have little doubt that it has prevented phlegmasia dolens in 
many instances ; and I am led to this conclusion, from the fact that no 
cases of this painful disease have occurred in my practice since it was 
adopted. Patients, however, are often unwilling to submit to it after 
delivery, when, as they express it, they 'feel so well.' And, in some 
cases, females entertain such a horror for medicine, that they will incur 
the danger of an attack of puerperal fever, rather than consent to take 
a cathartic, when they do not feel really sick." — Ibid. 

Treatment of Chorea by Frictions with Chloroform. — M. Gassier has 
published three cases of chorea cured by the topical application of 
chloroform. 

The first was that of a child, seven years of age, in whom the dis- 
ease was caused by fright. A liniment composed of equal parts of 
chloroform and oil of sweet almonds was rubbed, night and morning, 
along the course of the spine. From its first employment the violence 
of the muscular movements was moderated, and in six days the patient 
was cured. 

The second case was that of a boy, twelve years of age, in whom the 
disease had appeared two months before as the effect of fright. The 
spasmodic movements were so violent that he could hold nothing in his 
hands, nor walk without help. At the end of a fortnight, under chlo- 
roform frictions, the disease had disappeared. A relapse, however, 
occurred, which was cured in two days by a return to the same means. 

In a third case, of five months 7 standing, the result, also, of fright, 
the symptoms disappeared in seven days under chloroform frictions. — 
JJ Union Medicate, from Bostoii Journ. 



THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. IV. SIXTH MONTH (JUNE), 1851. No. 5. 

NEW JERSEY MEDICAL SOCIETY. 

Transactions of the New Jersey Medical Association. 

Report of the Standing Committee. 

Your committee regret to find themselves under the neces- 
sity of asking the indulgence of the Society, for the many 
imperfections of their report. The scanty materials to which 
they have had access, and the limited space over which their 
observations have extended will, they trust, be received as an 
apology for those imperfections : with but one exception, no 
reports have been received from the reporters of the district 
societies. The Committee have consequently been compelled 
to rely upon their personal observations and inquiries for 
the few facts herewith submitted. 

So far as these observations have enabled them to judge, 
the past year has been characterized by an unusual exemp- 
tion from fatal disease. Your Committee feel grateful that 
they have not like their predecessors of the previous year, to 
record the ravages of a wide-spread and fatal epidemic, be- 
fore whose desolating march the strong and the weak were 
alike stricken down. The cholera of 1849 would seem to 
have so materially exhausted the predisposition to disease, as 
to have rendered the ordinary endemic diseases of the West- 
ern District both fewer in number and milder in their na- 
ture, than during previous years. 

During the months of May and June, intermittents and 

remittents were more prevalent than ordinary at that season. 

They were, in fact, almost the only forms of disease met 

with in some parts of the district. They most frequently 

vol. iv. — 20 



230 NEW JERSEY MEDICAL SOCIETY. 

assumed the quotidian or tertian form, and were readily 
cured, yielding without difficulty to mild purgatives and the 
preparations of bark. 

As the summer advanced, diarrhoea, dysentery and cholera 
morbus made their appearance, though less frequently, and 
of a milder character than in ordinary seasons. They 
yielded readily to a treatment consisting of opiates and 
astringents in moderate doses, combined with occasional 
alteratives. 

The autumn, like the summer, was comparatively free from 
disease — intermittents and remittents were the prevailing 
affections. Like their predecessors of the spring, they were 
most generally mild and free from visceral complications of 
a severe form. The brain, so far as the observations of part 
of the Committee extended, suffered more frequently than 
the other organs, though serious cerebral irritation was by 
no means a frequent occurrence. 

The treatment differed in no essential feature from that 
practiced during their prevalence in the spring. Bleeding to 
a moderate extent, was thought by your reporter materially 
to assist the antiperiodic powers of the bark in those cases 
attended with much cerebral irritation. 

A few sporadic cases of measles and scarlatina were 
observed during the latter part of autumn. 

Bronchitis, pneumonia and pleurisy were less prevalent 
during the winter than for many years previous. Croup was 
occasionally met with, though by no means of frequent 
occurrence. 

The mumps and hooping-cough, may be considered as by 
far the most prominent diseases of the past year in the 
Western District. The former prevailed more extensively 
during the winter and spring than for many years previously. 
They are at this time the predominant disease in many 
localities. They attacked persons of all ages, though they 
were more frequently noticed in individuals under twenty 
years of age. The majority of cases were mild. Many, 
however, were severe, being frequently ushered in with a 



NEW JERSEY MEDICAL SOCIETY. 231 

chill, followed by fever, pain in the head, coated tongue and 
other evidences of high constitutional excitement. The 
parotid glands were in such cases often exceedingly painful 
and tender upon pressure. A number of instances of meta- 
stasis to the genital organs and brain, were observed. A few 
of these latter were attended with a fatal result. 

The treatment generally practiced in the less violent form 
of the disease, consisted of confinement to the house, the ex- 
hibition of saline purgatives, with the application of mild 
liniments and flannel to the throat. In the severer forms, a 
more active treatment became necessary. General bleeding, 
active purges, and the pretty free administration of nitre and 
the antimonials with stimulating liniments, and in a few in- 
stances blisters to the throat, were found to be most bene- 
ficial. A few grains of calomel, followed by a purge of sulph. 
magnes. and magnesia combined and preceded by a moderate 
bleeding from the arm was observed by the Chairman of the 
Committee to be particularly beneficial in those cases attended 
with much soreness of the throat and headache. 

The sympathetic irritation of the genital organs for the 
most part yielded readily to emollient applications to the 
organs themselves, and the application of stimulating lini- 
ments or blisters to the throat. 

As connected with the mumps, and most probably depend- 
ant upon a similar cause, your Committee would here notice 
the great frequency of inflammatory affections of the salivary 
glands, and of the smaller glands of the neck and throat. 
These local inflammations have been more frequently met 
with within the last few weeks, and they seem to be on the 
increase. There is generally much tenderness of the part 
upon pressure, accompanied with more or less tumefaction. 
A number of these cases witnessed by the Committee, have 
terminated in suppuration, notwithstanding a pretty active 
antiphlogistic treatment. They were more frequently ob- 
served in children than in adults ; and more frequently in 
young children than in those more advanced in years. 

Hooping-cough, which it will be recollected was noticed in 



232 NEW JERSEY MEDICAL SOCIETY. 

the report of the previous year, has prevailed with greater or 
less violence during the whole of the past year. Occasionally 
observed during the summer, it increased in frequency during 
the autumn and winter, and is still prevalent. Like the epi- 
demic of the previous year, it was sometimes complicated 
with bronchitis, cerebral excitement proceeding in some cases 
to such a degree as to cause convulsions was also not unfre- 
quently witnessed. Diarrhoea of a mild form was also an 
occasional attendant. The mortality from this disease most 
probably exceeded that from the same disease, during the 
previous year. The most frequent causes of death were pul- 
monary and cerebral irritation. 

The treatment of the uncomplicated forms of the disease, 
when they came under the care of the physician, consisted 
principally of confinement within doors, and the administra- 
tion of the various specifics recommended for hooping-cough. 
When combined with serious disease of the brain or lungs, 
the treatment proper in acute diseases of those organs was 
resorted to with success. 

REPORT FROM HUNTERDON COUNTY. 

To the Standing Committee of the New Jersey Medical 

Society. 

Gentlemen : — 

The undersigned, your reporter for the County of Hunter- 
don, would report that the diseases prevalent in the 
County the past year, have been those of the ordinary cha- 
racter, s. e. in early summer, diarrhoea and other intestinal 
irritations, caused by green fruit, &c. &c. Summer and 
autumn dysentery, and intermittent and remittent fevers, 
with nothing unusual either in their symptoms or treatment. 
Winter brought pneumonia, bronchitis, &c. These, with 
sporadic cases of erysipelas, &c, will comprise the diseases to 
which the attention of most of the physicians of the County 
has been called during the past year. An epidemic enteric 
fever has prevailed, however, to a considerable extent in the 
lower and middle portions of the County, for the whole of 



NEW JERSEY MEDICAL SOCIETY. 233 

the year. Your reporter having seen but few cases of the 
disease, and those only in consultation, he appends to this 
report an essay, read before the District Medical Society of 
the County, at the annual meeting this spring, by Dr. George 
P. Rex, which gives a fair and full account of the epidemic, by 
one who has seen it very extensively, and who has had cases 
under his charge constantly since the winter of 1849. I 
cannot do less than commend this essay to the notice of the 
State Society and to the profession generally, coming as it 
does, from a gentleman, who stands deservedly high in his 
profession, and whose success in the epidemic has been very 
remarkable.* 

It gives me great pleasure to state that the profession are 
becoming much more interested in the subject of keeping up 
a medical organization in the County, and that irregular prac- 
titioners are becoming fewer every year, and graduates are 
more ready and willing to comply with the requisitions of the 
law than heretofore. Had not the law been changed, your re- 
porter, from the information had, believes that a large number 
would have presented themselves to the board of censors for 
examination, and I shall be much disappointed if the Presi- 
dent of the State Society does not receive several applica- 
tions for diplomas from this County. 

This state of things is very gratifying to those of us who 
have kept our District Society alive against the opposition of 
a number of influential medical men in this County, where 
no society existed for a number of years. 

In conclusion, I must apologize to your Committee for this 
very crude report. Urgent professional engagements, and 
not being able to meet my professional brethren of the 
County until the Annual Meeting of the District Society, 
which was held yesterday, must plead my excuse. 

Very respectfully yours, 

SAMUEL LILLY, 
Reporter for Hunterdon County. 
Lambertville, May 7, 1851. 

* The Address here referred to, will appear in the July number of 
the Reporter. — Ed. 



234 NEW JERSEY MEDICAL SOCIETY. 

No instance of violation of the Medical Law has been 
officially presented for the action of the Committee, though 
it is well known that there are licentiates in every County of 
the State, who refuse to comply with its demands. 

The Committee have nothing new to offer upon the subject 
of quackery. It is still to be met with in its various forms, and 
with the exception of the County of Hunterdon, already noticed, 
has not materially diminished. Homoeopathy would appear 
to be its most prominent form. This, however, seems to have 
reached its culminating point, to give place, most probably, 
to some other equally absurd pretension. 

Among the medical events which have transpired during 
the past year, that which most immediately concerns this 
Society, is the passage by our recent Legislature of a " Sup- 
plement to the Medical Law." Of the importance of the 
Act referred to it will be unnecessary for the Committee to 
speak. They consider this, however, a fit opportunity to 
express their sense of the liberality displayed bj the Legisla- 
ture in thus granting the Society all that it asked. A year 
since, many of our members were justly apprehensive of the 
removal of all legal restrictions to the practice of empiricism 
within our borders, and that there then seemed to be strong 
grounds for entertaining such a belief, all conversant with the 
tone of public sentiment will admit. Those fears have, 
happily for the interests of medical science, proved ground- 
less. We believe the provisions of the Act referred to, afford 
the medical profession of New Jersey the surest guarantee 
that the community still entertains a proper sense of the im- 
portance of an educated and properly qualified class of phy- 
sicians. 

A query forcibly suggests itself to the Committee, while 
on this subject, viz., whether this renewed evidence of friendly 
feeling on the part of the Legislature does not render it still 
more incumbent upon this body so to conduct its future pro- 
ceedings, as to strengthen the confidence thus reposed in us. 
We have yielded something to the current of prejudice it is 
true ; but we have still retained all that we ought reasonably 



NEW JERSEY MEDICAL SOCIETY. 235 

to expect from legislative protection. Let us then inquire 
how we can, as members of a scientific body, thus protected 
in the enjoyment of many of our just rights and constituted 
the legitimate guardians of the public health, render broader 
and more palpable the distinction between ourselves and the 
legion of empirics, whose efforts to subvert our organization 
have been so recently defeated. 

The answer to this question, we are aware, is both difficult 
and delicate. Your Committee believe that there has hitherto 
existed among the profession throughout the State, too much 
of a disposition to rely upon legislative protection, to the 
exclusion of other efforts for the maintenance of our profes- 
sional standing. There is, in our opinion, a more efficient 
means of sustaining the character of our science, than this 
undue reliance upon legislative aid. Those means consist in 
more zealous efforts upon our part, for our mutual improve- 
ment. If we do not put forth unusual efforts to sustain the 
profession of our choice, assailed as it is on all sides by mer- 
cenary enemies, how can we hope for those less interested to 
hold it up. 

It cannot reasonably be expected that the medical men of 
New Jersey shall be in advance of their brethren in other 
places ; but it ought, and will be exacted of us, that we shall 
in future be fully up to the acquirements of the day. This 
desirable object can only be effected by systematic and well- 
directed industry. As a body incorporated for the promotion 
of scientific and humane objects, our responsibilities are far 
greater than they could become in our individual capacity. 
The eyes of the community will always be upon us. Com- 
parisons will frequently be drawn between us and the out-door 
pretenders to the healing art. We cannot hope, nor ought 
we to desire to escape the scrutiny of this free spirit of in- 
quiry, which is prying into every department of our science, 
and gradually undermining false props, wherever discovered. 
It were better then that we should knock away those false 
props ourselves than that it should be done by our enemies. 
Let us act the part of the " wise virgins," and be in readiness, 
against the day of trial, with our lamps well " filled with oil." 



236 DR. J. f. ward's address. 

Your Committee would respectfully direct attention to the 
well-timed suggestions contained in the report of the Stand- 
ing Committee of the previous year. The appointment of 
Committees, as therein recommended, to investigate and report 
the result of their researches into the more prominent dis- 
eases of certain localities, could not fail to elicit valuable 
information. 

In conclusion, they would particularly recommend a more 
thorough investigation of the Medical Botany of our State. 
There are, it is well known, in every county plants that en- 
joy more or less reputation as medicinal agents in their respect- 
ive localities. There are few of these but that would well 
repay the labor of a carefully digested report upon their thera- 
peutic properties. A series of cautiously conducted experi- 
ments in this branch of medicine, continued for a few years, 
would not only strip the designing empiric of much of the 
advantage which he now derives from his exaggerated boasts 
of their remedial virtues, and thus deprive him of half his 
power of deception; but, perhaps, might result in the dis- 
covery of an efficient substitute for some of the more costly 
foreign drugs now considered indispensable, and which often 
come to us so adulterated or damaged, as to be worthless for 
all therapeutical purposes. 

QUINTON GIBBON, ) 

THOS. J. SAUNDERS, V Committee. 

A. E. BUDD, J 



EMPIRICISM IN THE MEDICAL PROFESSION. 

An Address read before the District Medical Society for the 
County of JSssex, held at JSHzabethtown on the 29th of 
April, 1851. By John F. Ward, M. D. 

Gentlemen : — The position I occupy as your presiding 
officer, makes it incumbent on me to address you on this 



DR. J. f. ward's address. 237 

occasion. Since last we met, another great period of time has 
run its course ; another year has been added to the vast cycles 
of eternity. Varied, doubtless, are the events which have 
marked it in the experience of each of us ; but we can all 
mingle our congratulations over much of good that has sweet- 
ened the seeming ill of life, and from the lessons of the past, 
learn wisdom for the future. 

From the broad field of observation in which we have been 
severally employed, we gather here to make our annual con- 
tribution to the common fund of knowledge ; to receive and 
impart, to our mutual benefit. None of us can have been so 
unobservant of what has been passing before our eyes, in the 
different positions we have occupied, as not to have gleaned 
something which will be a more or less valuable addition to 
our previous acquisitions, and cause us to realize more fully 
the benefit to be derived from our organization. 

In this connection, allow me to suggest, that as members 
of this society, we should feel a responsibility, resting upon 
us individually, to contribute our quota, from time to time, 
towards rendering effective the object of our union. None 
here need be told what this object is. This society was estab- 
lished for the mutual improvement of its members ; not to be 
a mere gateway, through which others may pass with our 
recognized seal of approval and "license to practice." This 
latter, indeed, is an important view of the matter ; for if 
we are looked to by the public as the guardians of their 
health, and as those whose business it is to withhold, as far 
as in us lies, the honor and privileges of the " regular pro- 
fession" from those who are unworthy to share them, then, 
truly, is devolved upon us a weight of responsibility, of which 
none can be insensible. But this, we repeat, is not the prin- 
cipal design of our organization, but rather, as already stated, 
to receive and impart the benefits of our varied experience, 
and thus qualify ourselves for the more useful and honorable 
discharge of the duties of an arduous profession. 

If we have chosen this profession with a higher object in 
view than sordid interest, every feeling of our nature will 



238 DR. J. F. ward's address. 

conspire with the promptings of an enlightened conscience 
in the furtherance of our benevolent designs. Benevolent 
and philanthropic, we may justly call them, for it is a narrow 
view, which supposes that the influence of our actions here, is 
here confined, and reached not beyond these walls. 

There is one topic, gentlemen, of the very many which na- 
turally suggest themselves as appropriate for the occasion, 
upon which you will indulge me in a few brief remarks. 

We read much, and we hear more, almost every day, of the 
prevalence and progress of empiricism. The press, political 
and religious, teems with advertisements of "pectorals" and 
"balsams," "olosaonian" and "pain killing" salves, with reno- 
vating " elixirs'' and cordials, an interminable catalogue, all 
which are certified by hundreds of the "afflicted" and 
sworn toby " M. D.'s" of noted eminence (so we are informed), 
have restored health to thousands, and when properly appre- 
ciated and employed, are destined to rejuvenate the race. 

Then we have the whole race of quacks under the varied 
titles of "Botanic," " Thompsonian," "Eclectic," etc. etc. 

It is our design (while disclaiming the possession of all the 
learning and experience of the age in our own ranks) to ask 
if the " regular practice" can justly lay claim to a perfect 
exemption from all the forms of empiricism. Is not our prac- 
tice oft times too empirical ? Do we always bestow that time 
and patience in the investigation of the cases (frequently 
obscure) for which we are called to prescribe, which the 
reputation and dignity of the science demand at our hands ? 
Are we not too apt to take a superficial view, and prescribe 
this or that, because it cannot do harm, and may do good ? 
Whereas, if the case had been thoroughly examined, con- 
sidered in its varied aspects and relations, and with all the 
helps that knowledge and experience can bring to our aid, 
a result more creditable to our art, more satisfactory to our- 
selves and our patient, would have been the consequence. 

Were this course pursued in every case involved in any 
obscurity or doubt, there would be less of hap-hazard pre- 



DR. J. F. ward's address. 239 

scriptionfor "bilious" habits, for "liver" and " kidney" and 
a thousand other complaints ; terms satisfactory enough, per- 
haps, to the patient, content with a name, but as they really 
have no particular signification, and add nothing of definite- 
ness to our own conceptions, can only serve as cloaks to lazy 
ignorance. 

We are persuaded that this is a matter in which the pro- 
fession at large is vastly interested ; in which the interests of 
medicine as a science are deeply involved. We conceive that 
the plan indicated, if faithfully and patiently carried out, 
although it may be attended, for a time at least, with some 
personal inconvenience, will go far towards securing the com- 
munity against the swarms of impostors, of whatever school 
or name, who now practice on the credulity and ignorance of 
mankind : inasmuch as, aside from the incidental advantage 
of acquiring a habit of careful inquiry, we shall arrive, in 
most instances, at a prompt and correct diagnosis, secure for 
our art a corresponding confidence and respect, and do much 
towards elevating it to the rank and consideration it merits. 

One or two other suggestions occur to me, as conducive to 
the same end. To banish from the profession the empiricism 
upon which we have animadverted, it is not sufficient that one 
should amass a definite amount of medical lore, however great 
that may be. In the words of a recent author, " the physi- 
cian must be a thinking, observing, and reasoning man. One 
may be very diligent and industrious, and yet get no farther 
than this, through the whole period of his education. He 
may become an accomplished person, full of information ; a 
walking cyclopaedia, and at the end of his labors, may have 
attained the reputation of a learned and agreeable person. . 

" But is this sufficient to satisfy a man of ambition ? Far 
from it. One who thus limits his views can by no possibility 
become conspicuous in his profession, or ever prove useful to 
the community in which he moves. He may be learned, but 
he is not wise. He may be a cogent reasoner, but he wants 
practical common sense. He may be familiar with every 
authority under the sun, and yet fail to distinguish one dis- 



240 DR. J. F. ward's address. 

ease from another. He can tell you what Hippocrates and 
Galen say, but for himself he has no opinion. He forgot, in 
the outset of his career, that the best part of every man's 
knowledge is that which he has acquired for himself by ob- 
serving closely, pondering deeply, and diligently sifting the 
wheat from the chaff; a knowledge which cannot be commu- 
nicated to another, but which to him is a mine of gold." 

Let us not, therefore, trust too implicitly to what we are 
told or in what we read, but by our own labor and careful 
observation make our knowledge our own, recollecting that, 
however faithful may be our guides, "the goal can only be 
reached by traveling the road ourselves." 

Again, we should be honest. We do not mean, of course, 
the honesty which it is incumbent on all men, of whatever 
rank or profession, to practice in their ordinary business 
intercourse. Perhaps my meaning would be better expressed 
by saying we should be candid with our patients. Let us not 
claim for our art more than its due ; let us make no promises 
of any specific or infallible power in our remedies to heal. 

How often are such promises falsified by repeated failures, 
and either our honesty or our knowledge called in question ! 
The age is passed when the dicta of the physician are looked 
upon as oracular, and we shall fail in the attempt to revive it. 

Although our resources are many, and, when skillfully 
called in requisition, often adequate (with the blessing of the 
Great Dispenser of life and health,) to the alleviation and 
eradication of disease, yet daily experience proves the exist- 
ence, in numerous instances, of some unknown, some latent 
cause, some idiosyncrasy of constitution, which makes power- 
less, or positively injurious, those very remedies which, in 
other numerous cases, we have found potent for good. We 
have no panaceas. 

In no one particular is the true medical philosopher at a far- 
ther remove from the ignorant pretender to science than in this, 
that the one is conscious of the fact, and has the honesty to 
proclaim it, that all the resources of his art sometimes fail; 
while the other blazons his nostrum, the elixir vital, in the 



DR. J. f. ward's address. 241 

very ears of death. As already said, our resources are great ; 
and yet this assertion is not inconsistent with another, that 
in the whole list of the materia medica we have few, very few 
specifics. 

This may startle at first the young practitioner just enter- 
ing upon his professional career, whose mind, it may be, is 
hardly as yet disabused of the popular idea, that in the long 
catalogue of medicine there must be an antidote for every 
ache and pain that "flesh is heir to;" nevertheless it is true, 
as many a disappointed expectation will subsequently show him. 
And if it leads him to a closer observation of constitutional 
idiosyncrasy, of the phases of disease, and of those external 
circumstances which may be operative in modifying the effect 
of his remedial agents, so far from begetting a distrust in the 
true dignity and science of his art, and throwing him chart- 
less on the broad sea of quackery, he will see, as he advances, 
new lights, shedding a halo of brightness on the dark waters, 
and discovering objects which had hitherto lain concealed 
beneath the surface. 

He will also see that, notwithstanding all that lectures and 
books, and experience and observation (the best of all in- 
structors), may teach him, he will sometimes fail, and that 
therefore it is wise, it is best, both for his own reputation 
and the real advancement of his own profession, to deal 
honestly and frankly with all who may seek his professional 
advice. In the words of another, "do this," be thus honest, 
" and the doom of quackery is sounded, and the interests of 
our noble art materially advanced." 

Midst all the speculations and theories of vagarists, the 
great principles of our science will stand. They are founded 
on a basis that will bide the test of experience, and will come 
out of the crucible "like gold seven times purified." While 
themselves fixed and unchangeable, their fuller development 
will keep pace with the general advance of the age in all that 
is good and useful. 

May it be our noble endeavor to add some little at least to 
the knowledge of the past, and thus realize the satisfaction 
of him who is an acknowledged benefactor of the race. 



242 munn's case of misplaced after-pains. 



A Case of Misplaced After-pains. — By J. B. Munn, M. D. 

On the morning of Thursday, May 1st, 1851, Mrs. J. was 
taken in such rapid labor that the physician, Dr. J. L. Munn, 
found the child born, and the cord divided, without tying, by 
the woman herself (being alone) before he arrived — the pla- 
centa also being cast down in the vagina, and easily removed 
at once. The uterus was well contracted, and no unusual 
hemorrhage followed. After returning home, living about a 
mile distant, he was soon sent for again in haste, and, when 
he arrived, was informed by the female attendant that, in a 
short time after he left, she was seized with paroxysms of ex- 
treme pain in her head, and at the end of about an hour, a 
deluging uterine hemorrhage took place, which prostrated her 
to an extreme degree. The hemorrhage, however, had abated 
when he arrived; yet, for safety, cold applications were di- 
rected, and for the relief of the pain in the head a large 
dose of elix. anodyne was administered, without the effect of 
abating it. 

Friday, 2d. She complained of blindness, and the severe 
paroxysms of pain in her head, although there was no febrile 
excitement, no uterine pain, not the least abdominal soreness, 
nor lochial discharge. Directed large doses of morphine, to 
be repeated until relief of pain was procured. 

Sd. Symptoms the same as on the second ; very little abate- 
ment of pain in the head; accompanied with active fever. 
Directed ice to the head, and a large dose of sal. epsom and 
senna ; epispastic to the back of the neck, and sinapism over 
the uterus, after the cathartic had operated. 

Evening. The cathartic operated freely. Directed ten- 
grain doses of p. doveri every four hours, to relieve pain and 
produce sleep. 

4ith. Fever and pain in the head somewhat abated; ex- 
tremely feeble, and had fainting turns ; slight appearance of 
lochial discharge. Directed a repetition of the pulv. doveri, 
with occasional doses of spts. lav. and ammonia. At this time, 
the breasts were swollen, and some milk drawn from them. 



MINUTES OF THE NEW JERSEY MEDICAL SOCIETY. 243 

5th. No fever of any consequence, and very little pain in 
the head. Directed a repetition of the cathartic, with suit- 
able nourishment. 

6th. Convalescent. 

In obstetric practice, it is well known that pain in the head 
by paroxysms often precede and accompany the first stage of 
labor, and the pains called misplaced labor pains, subsequently 
change place in the right direction, and become regular par- 
turient pains ; yet it is believed that after labor, when an 
alarming and prostrating uterine hemorrhage has taken place, 
so as to bring the patient near deathj accompanied at the 
same time by an entire cessation of all uterine after-pains and 
hemorrhages, such pains shifting to the brain and acting 
there with regular intermission, alternately with severe parox- 
ysms, may be considered rare. It is proper to state that the 
action of ice, applied on the head, appeared for a short time 
to remove the pain down to the face, acting there with the 
same violence as in the head ; but all the while not the least 
return of pain was complained of in or contiguous to the 
uterus, nor the slightest appearance of lochia until Sunday, 
the 4th inst. 

Chatham, Morris Co., N. J., 1th May, 1851. 



Minutes of the late Annual Meeting of the New Jersey 

Medical Society.* 

The eighty-fifth annual meeting of the Society was held at 
New Brunswick, at Stelle's Hotel, May 13th, 1851. 

In consequence of the decease of the President, Dr. E. J. 
Marsh, the Society was called to order by Dr. J. H. Phillips, 
first Vice President. 

Certificates of delegation were read and accepted from the 

* [These minutes, although very promptly sent in, were not received 
until it was too late to insert them in their proper place. — Ed.] 



244 MINUTES OF THE NEW JERSEY MEDICAL SOCIETY. 

following District Societies, viz., Essex, Passaic, Sussex, 
Somerset, Monmouth, Burlington, Hunterdon, and Mercer. 

Fellows present : Drs. Munn, Craig, L. A. Smith, Goble, 
McKissack, Vanderveer, Schenck, R. S. Smith, and J. T. B. 
Skillman. 

The minutes of the preceding meeting were read and ap- 
proved ; also the list of Licentiates for the preceding year. 

The following were appointed Committee on Treasurer's 
Accounts : Gibbon, Craig, and Woolverton. 

On unfinished business: L. A. Smith, J. T. B. Skillman, 
and R. Laird. 

The Chairman of Standing Committee, Dr. Gibbon, sub- 
mitted the Annual Report, which was accepted, and ordered 
to be laid upon the table. 

The committee to whom had been referred the revision of 
Charter and Bye-laws, submitted their final report in relation 
to the Bye-laws, proposing sundry amendments, which amend- 
ments were considered, amended and adopted. On motion, 

Resolved, That the Bye-laws, as amended, be considered as 
taking effect on and after the fourth of July next, so far as 
they relate to the supplement recently enacted by the Legis- 
lature. 

Resolved, That a new edition of one thousand copies of the 
Charter, Supplement, and amended Bye-laws, be printed 
under the care and supervision of the former committee, with 
authority to make such farther grammatical corrections as 
they may deem essential. 

A communication was submitted by the Secretary from 
Dr. Wood of Philadelphia, Chairman of the Committee on the 
Revision and Publication of the United States Pharmacopoeia, 
stating that sixteen copies of the said work was the quota 
allotted to this Society from the sale of the copy-right, free 
of all charges. 

A communication was received from Dr. Paul, relative to 
a State Medical Library, with the following resolutions: 

1. Resolved, That a committee be appointed to examine 
and report on the expediency and propriety of establishing a 



MINUTES OF THE NEW JERSEY MEDICAL SOCIETY. 245 

Medical Library; and, if favorable, to submit a plan for 
carrying the same into effect. 

2. Resolved, That of the moneys accruing from license 
fees, after defraying the necessary expenses of the Society, 
such sum as the members shall deem meet, shall be appro- 
priated to the library fund, for the purchase of such medical 
works as the Library Committee may from time to time de- 
termine upon. 

The consideration of the communication and resolutions 
was postponed to the next meeting. 

On motion of Dr. L. A. Smith, a nominating committee of 
one from each district represented was ordered, and the fol- 
lowing appointed, viz., Drs. Craig, Culver, Coles, Morford, 
Polhemus, J. Haines, Woolverton, and Lilly. 

The following resolution, submitted by Dr. J. B. Coleman, 
was adopted: — 

Resolved^ That the following committees be appointed to 
report progress at the next annual meeting, viz: — 

1st. To investigate the chemical action of the kidneys, and 
their influence on the healthy condition of the structures. 
Committee — Jos. Parrish, Job Haines, and S. W. Butler. 

2d. To investigate the effects of blood-letting upon the 
vital organs. Committee — L. A. Smith, A. Coles, and A. 
N. Dougherty. 

3d. To investigate the action of mercurial preparations on 
the living animal tissues. Committee — J. B. Coleman, I. P. 
Coleman, and J. Woolverton. 

4th. On the indigenous plants of New Jersey. Committee 
— J. Paul, Q. Gibbon, J. G. Goble. 

The committee on Treasurer's Account reported the ac- 
counts correct, and a balance on hand of $300 83J. 

Resolved, That the treasurer pay the instalment required 
by the directors of the State Bank of New Brunswick on all 
shares owned by this Society in said bank, and also all future 
instalments which may be required by said directors. 

The committee on Benevolent Fund, by Dr. Gibbon, stated 
that they would not be prepared to report at this meeting. 
vol. iv. — 21 



246 MINUTES OF THE NEW JEESEY MEDICAL SOCIETY. 

Resolved, That Dr. J. H. Phillips be appointed to fill the 
vacancy in said committee, occasioned by the death of Dr. 
Marsh. 

The following bills were ordered to be paid, vizi- 
New Jersey Journal for advertising, $1 75. 

Dr. S. H. Pennington's bill of expenses to Trenton, $7 05. 

Dr. Pennington's bill of expenses to American Medical As- 
sociation, any sum not exceeding $40. 

Upon the report of the nominating committee, the follow- 
ing were appointed officers : — 

President, J. H. Phillips, of Pennington, Mercer Co. 

1st Vice-President, 0. H. Taylor, Camden. 

2d " " W. Nichols, Essex. 

M " " S. Lilly, Hunterdon. 

Corresponding Secretary, A. B. Dayton, Middletown, Mon- 
mouth Co. 

Recording Secretary, W. Pierson, Orange, Essex Co. 

Treasurer, J. S. English, Manalapan, Monmouth Co. 

Standing Committee, J. Paul, of Trenton, Chairman ; J. B. 
Munn, and A. Coles. 

Censors — For Passaic, L. Burr, A. W. Rogers, G. Terhune, 
F. S. Weller. 

For Essex, A. N. Dougherty, W. Nichols, J. F. Ward, W. 
A. Whitehead. 

For Morris, J. B. Munn, J. C. Elmer, J. B. Johnes, N. W. 
Condict. 

For Sussex, F. Moran, I. R. Stewart, A. Linn, J. Tits- 
worth. 

For Warren, W. P. Clarke, R. Byington, P. Brakely, J. 
Fitch. 

For Somerset, R. F. Smith, H. H. Vanderver, S. K. Mar- 
tin, W. D. McKissack. 

For Monmouth, D. Polhemus, W. A. Newell, J. S. Eng- 
lish, E. Taylor. 

For Burlington, B. H. Stratton, Z. Read, Geo. Haines, J. 
Parrish. 



A NOVEL CASE. 247 

For Mercer, J. Paul, J. B. Coleman, G. R. Robbins, J. H. 
Phillips. 

For Hunterdon, W. Johnson, G. P. Rex, J. Blane, S. Lilly. 

For Camden, L S. Mulford, 0. H. Taylor, C. D. Hendry, 
A. D. Woodruff. 

For Gloucester, J. R. Sickler, J. F. Garrison, J. C. Wea- 
therby, R. M. Smallwood. 

For Salem, C. Hannah, C» Swing, Q. Gibbon, T. Yarrow. 

For Cumberland, W. Elmer, G. Tomlinson, E. C. Bateman, 
J. W. Ludlam. 

Hesolved, That hereafter, appointment of delegates to the 
American Medical Association will be made with the under- 
standing that no pecuniary remuneration for expenses will be 
paid by the Society. 

The following were appointed delegates to the American 
Medical Association — Drs. J. G. Goble, J. W. Craig, J. Paul, 
J. Parrish, J. B. Coleman, and J. H. Phillips. 

Stelle's bill for entertaining the Society was ordered to be 
paid— $50 63. 

A petition was received for a commission to institute a Dis- 
trict Society in Hudson County. The request was granted, 
and the blanks ordered to be filled, as the applicants may 
give further notice. 

Society adjourned, to meet at Trenton on the fourth Tues- 
day of January, 1852. 



W. PIERSON 



Bee. Sec. of Med. Soe. of N. J. 



A Novel Case. 



BY THE EDITOR. 



On the 13th ult. I was called to a lady in her second ac- 
couchement* Five years had elapsed since her first confine- 



248 A NOVEL CASE. 

ment, in which she suffered a tedious and painful labor, and 
was delivered by instrumental aid of a still-born foetus of full 
size. Her recovery was slow, but without any unusual symp- 
toms. In her first labor, her physician administered ergot 
freely, which powerfully increased the uterine contractions. 
During her second pregnancy, I saw her very frequently, and 
she complained much of an unusual sense of distension, even 
during the earlier months. She described it as a weight 
about the pubic region, and frequently she had a quivering 
sensation, which gave her the idea of worms crawling within 
the abdomen; with these feelings she experienced difficulty 
in urination; and, supposing that the bladder was unduly 
pressed upon by the enlarging uterus, I directed her to wear 
a bandage around her hips, for the purpose of supporting the 
abdomen and its contents. From the time of quickening up 
to the period of labor, the motions of the child created un- 
usual suffering ; and when she rode out, though in a very easy 
carriage, she was under the necessity of supporting her body 
in great measure by pressing her hands upon the seat, to pre- 
vent the excessive pain produced by motion. I was disposed 
to attribute all these symptoms to a peculiar sensitiveness of 
the individual, induced by her situation, as well as to a fear 
that the child might not live, or be carried to the full term of 
utero-gestation, without unusual care. In due time her labor 
commenced, the os uteri dilated readily, and the head, pre- 
senting in the second position of the vertex, advanced readily 
into the inferior strait. Here it encountered opposition from 
the rigidity of the vaginal muscles, which I found to be full 
and unyielding. There was but an imperfect supply of liquor 
amnii, which was spontaneously evacuated during this period 
of the labor. The contractions being very powerful, the re- 
sistance to the passage of the head still continuing, and the 
parts without a sufficiency of the natural secretion, I etherized 
my patient, and delivered by the forceps a well- developed, 
living female child. The hemorrhage was considerable, 
though no more than might be expected from a plethoric per- 
son such as my patient. The uterus contracted under the 



A NOVEL CASE. 249 

hand, and the placenta came away entire. After this, every- 
thing promised well for more than two weeks ; the patient 
was about her room, and several times walked into an adjoin- 
ing apartment. In the third week, a rather offensive lochial 
flow preceded the discharge of clots of a clear red color, vary- 
ing considerably in size, the expulsion of which, though unat- 
tended by any premonitory or expulsory pain, brought on 
threatening prostration. Fever now set in, the pulse became 
tense and rapid, the complexion sallow, with frontal head- 
ache, and dejected spirits. In the fourth week, soon after 
one of my morning visits, I was sent for in great haste to 
return, and did so immediately, and found her in an alarming 
condition. The hemorrhage had increased, and my patient 
looked almost ex-sanguine ; the pulse was faint, and the voice 
nearly extinct. Brandy and ammonia were given freely, 
while I introduced my hand into the vagina. Embraced by 
the os uteri I felt a thick, hardened, ragged mass, which I 
hooked with the point of my finger, and, finding it detached 
and movable, I at once withdrew it. It was an organized 
body, weighing, I suppose, six or eight ounces ; in color and 
consistence resembling liver upon its upper or outer surface, 
with white tendinous chords attached to its inner portion, 
within an inch of its periphery. The shape of the substance 
was somewhat cupped, as though it had been attached to the 
fundus, and part of the walls of the uterus. The inner sur- 
face was ragged, and attached to it were numerous clusters 
of little granular bodies, resembling very much the roe of 
fish, but exceedingly tenacious, and hanging by minute 
chords, which ramified through them like the tendrils of a 
vine. The os uteri was flaccid, and seemed indisposed to con- 
tract. I applied compresses over it, and a roller about the 
body, elevated the hips, and gave an ounce of wine of ergot 
in divided doses; stimulating vaginal injections were also 
administered frequently. The uterus gradually contracted, 
expelling for a day or two afterwards, in small quantities, the 
same kind of roe-like substance in distinct parcels, but unat- 
tended with serious bleeding or pain. After this, the general 



250 A NOVEL CASE. 

symptoms began to improve, and I now consider my patient 
convalescent. 

The vesicular peculiarities which distinguish hydatids, and 
the fluid contained in them, were not apparent in the morbid 
production I have attempted to describe ; and yet that it be- 
longed to the mole species must be admitted. The difference 
between the clusters of the organized substance referred to, 
and hydatids, consists mainly in their solid, tough, granular 
feel, rolling between the fingers like small shot or seeds, and 
being with difficulty separated from their attachments, while 
that portion of the mass from which they were suspended 
was fleshy, and in some parts decidedly tendinous. 

Another peculiarity in the case I conceive to be, the fact 
that this development should have progressed during the 
growth of a perfectly formed child in utero, thus proving that 
a purely physiological effort of nature, in perfecting the 
growth of a human being, and an abnormal or pathological 
effort, induced of course by an unnatural and diseased con- 
dition, resulting in the formation of an amorphous mass of 
organized tissues of different qualities, should go on at the 
same time within the walls of the same organ. 



BIBLIOGRAPHICAL NOTICES. 



The Pharmacopoeia of the United States of America. By 
Authority of the National Medical Convention, held at 
Washington, A. D., 1850. Philadelphia : Lippincott, 
Grambo & Co. 

We are among the number who regard with pride and 
satisfaction our National Pharmacopoeia- — that it merits the 
respect and close observance of both the medical and pharma- 
ceutical professions is a conviction which has been strength- 
ened by an intimate acquaintance with its details, and a daily 
recurrence to its pages. 

The present is the fourth edition of the work, and fully sus- 
tains the high reputation which its predecessors have enjoyed, 
and which would be expected from its origin and object. Unlike 
its predecessors, the present edition is the joint product of the 
best authorities in both the medical and pharmaceutical pro- 
fessions. It is true that in the revision of 1840, the Philadel- 
phia College of Pharmacy took a lively interest, and furnished 
to the Convention a complete revised Pharmacopoeia from 
which a great many valuable hints were drawn and applied in 
the final revision, but not until the present edition had the full 
benefit of the practical skill, and familiarity with details, of a 
body of educated apothecaries been obtained. Both in the Con- 
vention held in Washington, and in the committee having 
charge of the final revision and publication, which met in Phil- 
adelphia, the Philadelphia and New York Colleges of Pharmacy 
were represented, and faithfully and unitedly labored in the 
work. 

The composition and proceedings of the Convention and 
committee are detailed in an historical introduction to the 
work, in which it is shown how so great a work, necessarily 



252 BIBLIOGRAPHICAL NOTICES. 

the labor of but a very few individuals, is rendered national 
as its origin, while the work itself bears evidence throughout 
of a truly national character and scope. 

An object which seems to be kept constantly in view, is to 
embrace in the Pharmacopoeia, only really valuable and well 
established medicines. Among the multitude of new remedies, 
whether drugs or preparations, which are constantly rising to 
the surface, as it were, of that vast chaotic mass of materials 
called the materia medica, not a few attract a temporary notice, 
and, in a very few years, sink again into oblivion. If every 
article of this kind were incorporated into the Pharmacopoeia 
as soon as introduced, it is obvious that we should cumber 
each new edition of the work with a variety of articles which 
would have to be stricken out in the next. Partly with a view 
to obviate this difficulty, and also to confine the officinal list 
within narrower bounds than would otherwise be possible, the 
Pharmacopoeia of the United States contains a secondary list, 
which embraces a variety of drugs, not very often prescribed, 
yet having been at one time in vogue, or being in use perhaps 
in a limited section of country, or being indigenous to our own 
country, and little known to practitioners, require some notice. 
In the new edition, we find four substances transferred from 
the secondary to the primary list, as having attained a higher 
reputation during the past ten years ; these are Bromine, 
Irish Moss (Chondrus), Marsh Rosemary (Statice), and 
Queen's Root (Stillingia). The drugs made officinal for the 
first time are sixteen in number ; among them the most import- 
ant are Aconite Root, Cod Liver Oil, (Oleum Morrhuse,) Oil 
of Bitter Almonds, Brandy (Spiritus Vini Gallici), and Port 
Wine, (Vinum Rubrum.) In the above remark reference has 
been had to the materia medica list, as distinguished from the 
preparations. This consists merely of a list of recognized 
drugs found in commerce, with their proper names, sources, 
and tests of purity. 

The preparations occupy by far the larger part of the 
work, comprising formulae for all the recognized medicinal 
compounds prepared by the apothecary, with such descrip- 



BIBLIOGRAPHICAL NOTICES. 253 

tions of them as will direct the physician or pharmaceutist in 
judging of their quality and strength when prepared. It was 
in revising this portion of the work that by far the greatest 
amount of labor and practical skill was requisite, and the 
greatest room allowed for addition and improvement. Yet 
here, as in the list, great care seems to have been taken not 
to add anything which is not absolutely called for by the ex- 
isting state of pharmacy. While it is desirable to have author- 
itative formulae in all instances in which variations in strength 
would be followed by serious inconvenience, great caution 
must be used in giving the sanction of the law to any prepara- 
tion having a mere local or circumscribed reputation, or which 
is not likely to become a general remedy. The multiplication 
of officinal formulae for compounds has direct tendency to 
circumscribe, rather than to enlarge, the number and variety of 
medicinal preparations ; by saving the practitioner the trouble 
of contriving an extemporaneous compound, exactly adapted 
to the case, it presents him a temptation to use one which, 
though perfect in itself, cannot be considered perfectly adapted 
to all the variations in disease. Hence the U. S. Pharma- 
copoeia contains few mixtures, pills, or compound powders, 
these being left mainly to extemporaneous prescription. 

There are, however, fifty-three new preparations introduced 
into the present edition : of these some are chemical, and some 
tinctures, syrups and extracts. We also have a new class of 
preparations, for the first time recognized as officinal— the 
fluid extracts. — This is one of the most desirable improve- 
ments that has been made ; though we cannot but regret that 
preparations so very distinct in their characters, as fluid ex- 
tracts of senna (a concentrated syrup), and fluid extract (oleo 
resin) of cubebs, should be classed under the same general 
head. Donovan's solution, solution of nitrate of iron, and 
solution of citrate of magnesia, will be welcomed, especially as 
the formulae for preparing them are distinguished by great 
simplicity and neatness. A further notice of the new prepa- 
rations would perhaps hardly be appropriate here, as it would 
extend the limits of this notice beyond the allotted space. 



254 BIBLIOGRAPHICAL NOTICES. 

Before concluding, however, it is proper to remark upon the 
general execution of the book : — The printing is done in the 
very best manner, upon remarkably fine paper, and the whole 
is furnished in a neat and substantial binding, as it should be. 
To this, however, we feel constrained to add, that the pub- 
lishers have issued but a small edition, at what we consider 
an exorbitant price. That this is just cause of complaint, will 
appear when we state that the whole number of pages is 317, 
including preliminary notices and all ; it contains no illustra- 
tions, the margins are wide, the type large, and yet it is sold 
at $2 50 per copy. It ought to be a cheap book, and widely 
diffused. We also desire to call attention to two or three 
slight errors which have escaped the proof-readers. In the 
formula for tincture of ginger by the displacement process, the 
term diluted alcohol is used instead of alcohol. In the formula 
for compound syrup of sarsaparilla by displacement, page 228, 
the term two pints is used instead of ten pints. This is cor- 
rected in part of the edition. In the preface, page xvii, 
Quercus Tinctoria is spelled Tinctorea, and on the next page 
Foeniculum is spelled Foeniculun. Considering the great 
care taken in the revision of this work, and the number and 
character of the proof-readers engaged in it, these mistakes 
may be considered as indicating the impossibility of reaching 
perfection in any human undertaking. E. P. 



EDITORIAL, 



THE MEDICAL LAW AGAIN. 

In our last number we noticed some of the features of the 
supplement to the medical law as passed by our late legisla- 
ture ; and we have now to do with such parts of it as seem to 
us the most objectionable. The second section of the act 
provides that "any person of good moral character, who has 
obtained a diploma for the degree of Doctor of Medicine and 
Surgery, from the College of Physicians and Surgeons in the 
city of New York, the Medical Department of the University 
of the city of New York, the Medical Department of the 
University of Pennsylvania, Jefferson Medical College, and 
the Medical Department of Pennsylvania College, in the city 
of Philadelphia, or such other Medical College or University 
as the Medical Society shall from time to time designate, to 
present such diploma to the President of the Medical Society 
of New Jersey, together with the testimonials of his good 
moral character ; and the president of said society shall 
thereupon, if satisfied with such testimonies, be authorized 
and empowered to grant a license, under his hand and seal of 
the society, to the person named and intended in said diploma, 
to practice physic and surgery in the State of New Jersey ; 
for which the said president shall be authorized to demand, 
from the person so licensed, a sum not exceeding five dollars, 
to be appropriated in such manner as the members of the said 
society shall order and direct." 

Now we do not hesitate to express our belief that the pro- 
visions of this section are unfair, and totally inconsistent with 
the spirit of wise and just legislation. We do not say that 
its framers intended this to be the case — we believe they did 
not — but we think that, in the practical operation of the law. 



256 EDITORIAL. 

its unfairness must be evident, because it overlooks the great 
fundamental principle, without the recognition of which the 
people never will be secure from the ravages of charlatanism, 
nor the profession free from those stains which have too long 
tarnished its honor and impaired its usefulness. It does not 
establish merit as the standard by which the applicant for 
license is to be judged ; it provides against his immorality, 
but not against his ignorance, while ignorance is the parent 
of mischief. Neither is the law democratic. It offers privi- 
leges to the student of medicine whose preceptor may reside 
out of our state, which it refuses to allow to those within our 
borders. New Jersey has always maintained a position in 
advance of other states. We now have in existence the oldest 
medical institution in the Union, having power to confer the 
doctorate, and to permit, by license, persons to practice medi- 
cine and surgery ; which has established, and in great mea- 
sure sustained, a curriculum higher and broader than is en- 
forced by any medical college in the United States. The 
law has confirmed, in the fifth section of the supplement, the 
old and long-established rule that four years study is neces- 
sary for an applicant for license ; whereas, in each of the 
medical schools enumerated in the law, the standard of re- 
quirement is really less ; and yet their graduates are per- 
mitted, without examination, from the mere fact that they 
possess a diploma, and a certificate of good moral character, 
no matter whether they have studied medicine two or four 
years, to take the same position which our own citizens must 
undergo a more severe ordeal in order to obtain. A Jersey- 
man is thus required by the law, as well as by the regulations 
of the medical society, to have more general information, in 
addition to an equal amount of medical knowledge, and to 
devote one more year to his studies, unless he shall possess 
an academical diploma, than a person from any other state. 

We ask if this is fair ? We do not, however, advocate such 
an alteration of the law as would lower the standard which it 
has wisely established, but such a modification of its provi- 
sions as will cause applicants for license from all parts of the 
country to be tried by the same standard, and the validity of 



EDITORIAL. 257 

their claims to enter our profession tested by the same au- 
thority. While the people talk of the " uncertainty of medi- 
cine," and presume to judge the science a mere scheme for 
self-aggrandizement, gotten up by interested men, and 
shrouded in vague and mysterious terms to hide it from the 
common observer, we must say that we regret to find our 
legislature disposed to open the door for empiricism any wider, 
or make the road any easier for ignorance or knavery to ac- 
quire a power and influence, which cannot be other than pre- 
judicial to the public weal, rather than maintain the position 
which the State and the profession have always held. It is 
true that the Medical Society is at liberty to "designate" 
from time to time such institutions as it may approve, and only 
to admit their graduates without examination ; but we think we 
utter the sentiment of the entire profession of our State when 
we say that this it will not do. It is an independent body, 
having no league with this school or that, looking with a just 
jealousy upon the graduates of all, while it is willing to give 
to all who seek its honors, and merit them, equal privileges ; 
but it claims to judge for itself, and to establish its own stand- 
ard of merit. The law, however, in its present form, to a 
certain extent, judges and decides the matter itself, and of 
course its authority is supreme, and must be faithfully acknow- 
ledged and obeyed; but we hope to see the New Jersey Medi- 
cal Society maintaining all the ground that is left to it ; and 
we look forward with a good degree of hope that our people 
and our legislators will see the inconsistency and unfairness 
of the present act, and be prepared before long to rectify its 
errors. Our pages are open for the views of our friends upon 
this subject, and we hope the matter will be fairly considered 
and properly understood. 



Phosphate of Lime, — We see it announced that Dr. C. T. 
Jackson, of Boston, has — allowing that his claim to being the 
first discoverer of the ansesthetic action of ether is valid — 
added another laurel to his brow, which, with all due deference 
and respect, we must say ought to have been worn by some 
one of our own physicians or other scientific men. 



258 EDITORIAL. 

We refer to the discovery in Hurdstown, Morris Co., in 
this State, of a rich bed containing 92 T 4 n per cent, of pure 
phosphate of lime, yielding 46 J per cent, of phosphoric acid } 
and 20 per cent, of phosphorus. 

This discovery will be of very great importance to our 
farmers and manufacturers. 

The field of Waterloo, and other battle-fields, furnished the 
English farmer with manure to enrich his lands, so that the 
soldier not only poured out his life blood to preserve the 
liberties of his country, but his very bones were ground to 
powder to enrich her meadows. 

We have no Waterloos to furnish us with human bones, 
but we have, it seems, what is much better, beds of almost 
pure phosphate of lime, which, we presume, will be made use 
of by our farmers. 

To the manufacturer, too, this discovery is one of great 
interest, as it gives him the material from which to procure 
an abundant supply of phosphorus, which is used in many 
departments of the arts, as well as to a small extent in 
medicine. 

At present, phosphorus is manufactured, by a slow process, 
from the bones of animals, which contain, according to the 
highest estimates, only from 55 to 60 per cent, of the phos- 
phates of lime and magnesia. But here we have rich beds 
containing 20 per cent, of pure phosphorus. We repeat that 
we regret that it was left for a Boston physician to bring 
forward a discovery which, if true, is so important. * 

American Medical Association. — This Association met in 
Charleston, S. C, on the 6th ult. For the detailed account 
of the proceedings which appears in this number we are in- 
debted to the Charleston Courier of May 6th, 7th, 8th, and 
9th, through the politeness of Dr. S. H. Pennington, of New- 
ark, delegate to the Association from the New Jersey State 
Medical Society. We have been obliged to add several pages 
to this number, notwithstanding which some matters intended 
for insertion are crowded out. * 



editor's table. 259 



EDITOR S TABLE. 



We have received the first number of the Nashville Journal 
of Medicine and Surgery, edited bj W. K. Bowling, M. D., 
Professor of the Institutes and Practice in the Medical De- 
partment of the University of Nashville, Tennessee. Judg- 
ing from the appearance and contents of this number, it 
seems to be well worthy the patronage of the profession, 
especially of those interested in the prosperity of the college 
with which the Journal is connected. The first session of 
the Medical Department of this college is announced to com- 
mence on the first Monday in November next. We will be 
happy to exchange with the above Journal, and wish it 
success. * 

Homoeopathy Illustrated. An Address first Delivered before 
the Rensselaer County Medical Society, in 1842. By Thos. 
W. Blatchford, M. D., President. Second edition, 1851. 

This is an excellent Address, and exposes effectually the 
absurdities of homoeopathy as first promulgated by Hahne- 
mann. But in most respects it is "behind the age;" for 
homoeopathy is not now what it was in 1842. The idea of 
infinitesimal doses, and uncompounded remedies, would startle 
a modern homoeopathist. We wonder how the manes of 
Hahnemann and other "fathers" of the homoeopathic school 
can rest while there is such an awful "sacrifice of human 
life,'' by their professed followers, who do not scruple to give 
castor oil, magnesia, calomel, &c, in doses that "tell tales," 
to say nothing of arsenic, hyoscyamus, digitalin, strychnine, 
etc., which can very easily be given in "homoeopathic" doses 
in a little sugar of milk. 

We would here acknowledge also the receipt from a friend, 
of a pamphlet, entitled, " The Physician and the Public." It 
is from the press of Myers & Son, Beading, Pa., but the 
modest author has withheld his name. The pamphlet con- 
tains a very plain, common sense exposition, in few words, 



260 editor's table. 

of the reciprocal duties of the physician and the public, and 
we are glad to learn that a second edition is called for. * 

A Contribution to the Statistics of Rupture of the Urinary 
Bladder, with a Table of Seventy-Eight Cases. By Stephen 
Smith, M. JD., Assistant Surgeon to Bellevue Hospital, New 
York. 

We are indebted to the author for a copy of this valuable 
pamphlet, which first appeared in the New York Journal of 
Medicine. The table of cases includes the sex, age, cause, 
primary symptoms, progress and treatment, result, post-mor- 
tem appearances of viscera, ditto of bladder, condition of the 
patient at the time of accident, authority. * 

We have also received the " Thirty-Fourth Annual Report 
on the State of the Asylum for the Relief of Persons de- 
prived of their Reason, together ivith the Constitution of the 
Contributors to said Asylum." 

This Institution is located at Frankford, Pa. * 

Catalogue and Announcement of the Medical Department 
of Hampden Sidney College, Richmond, Va. 

This college seems to be in a flourishing condition. The 
class, during the session of 1850-51, numbered 90, of whom 
26, or one in 3.46, graduated at the close of the term. * 

Miscellany. — An Act providing for the registration of births, mar- 
riages, and deaths, passed the Legislature of Pennsylvania at its recent 
session, and has become a law. Chloroform has been administered in 
9000 cases, in St. Bartholomew's Hospital, London, without one unplea- 
sant occurrence taking place from its use. Professors Bartlett and Gross, 
who were recently elected to chairs in the New York University, have both 
resigned. Dr. A. L. Cox has also resigned his professorship in the New 
York Medical College. This leaves four vacant professorships in Medical 
Colleges in that city. A new Hospital is about to be established in 
Philadelphia, in connection with the Protestant Episcopal Church, 
which, however, will be open to patients of all denominations. The 
British government has granted a pension of one hundred pounds a 
year to the widow of the late Robert Liston. The Medical College of 



TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 261 

Ohio, located at Cincinnati, has in course of erection a new and magni- 
ficent edifice in the domestic Gothic style of architecture. This College 
seems to be in a flourishing condition. . * 

Obituary. — "We regret to have occasion to notice, in connection with 
the decease of S. G. Morton, M. D., of Philadelphia,* that of several 
other physicians whose names and services are well known to the pro- 
fession. 

Our neighboring city of New York has lost recently several of her 
prominent physicians by the ravages of typhus fever. Among them we 
notice the names of Dr. Enoch Greene, Dr. Henry H. Curtis, Drs. Taft, 
Cameron, and Alden, and Dr. H. W. Gridley, most or all of them con- 
nected with public charities in or near New York. 

Dr. JohnB. Beck, late Professor of Materia Medica, in the College of 
Physicians and Surgeons in New York, died on the 9th of April last. 
We learn that his place has been filled by the election of Dr. Bartlett, 
late of the N. York University. * 



Transactions of the American Medical Association. Charles- 
ton, S. C, May 6-9, 1851. 

This Association met at 11 o'clock yesterday, at St. Andrew's Hall, 
Broad Street, their President, Dr. Mussey, in the chair, and Dr. H. W. 
Desaussure, Secretary. 

The Association having been organized, Dr. Thos. Y. Simons, the 
Chairman of the Committee of the South Carolina Medical Association, 
in a warm and hearty address, welcomed the delegates present from the 
other States, to the city and State, on behalf of his associates, which 
Was responded to in a becoming manner by the President. 

The President of the Association read a letter from Dr. Stille, re- 
signing his office, in consequence of the impaired state of his health. 

On motion of Dr. Arnold, of Savannah, Ga., it was proposed that 
the letter of Dr. Stille be placed on record, in compliment to him, for 
the interest he has manifested in the Association. 

Dr. Arnold offered the following resolution, which was adopted: — 

Resolved, That a committee of one from each State represented in the 
Association, to be chosen by their respective delegates, be appointed to 
nominate suitable officers to be elected for the ensuing year. 

On motion of Dr. Frost, the Association took a recess often minutes, to 
enable the delegation to appoint one of their number a member to con- 
stitute the Nominating Committee, in compliance with the above resolu- 
tion. 

The President of the Association, at this stage of the proceedings, 

* An obituary notice of the late Dr. S. G. Morton, prepared for this number, is 
crowded out.— Ed. 

vol. iv. — 22 



262 TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 

read an address of some length on matters connected with the profes- 
sion, and the advancement of medical science, which circumstances pre- 
vented us from hearing, but which we learn was well received, and 
elicited the commendation of those present. 

On the re-assembling of the Convention, the President reported the 
following gentlemen, as having been selected by said committee from 
the different State delegates, viz : Dr. Geo. Mendenhall, of Ohio : B. R. 
Wellford, of Virginia ; Joseph Fithian, of New Jersey ; R. D. Arnold, 
of Georgia ; G. W. Miltenberger, of Maryland ; H. R. Frost, of 
South Carolina; N. G. Pittman, of North Carolina; W. H. Ander- 
son, of Alabama ; A. H. Stephens, of New York ; Usher Parsons, of 
Rhode Island ; Jos. Carson, of Pennsylvania ; H. Adams, of Massa- 
chusetts ; Thos. Reyburn, of Missouri ; Jas. Jones, of Louisiana ; W. 
Parsons, of Rhode Island 1 ; J. B. Flint, of Kentucky ; John Sloan, 
of Indiana; C. Boyle, of the District of Columbia; and J. B. Linds- 
ley, of Tennessee. 

The Nominating Committee, through the chairman, then read the sub- 
joined names as suitable candidates for officers of the Association for 
the ensuing year, viz : — 

Dr. JAMES MOULTRIE, of S. C, President. 

Dr. GEO. HEYWARD, of Mass., Dr. R. D. ARNOLD, of Geo., Dr. 
B. R. WELLFORD, of Ya., Dr. J. B. FLINT, of Kentucky, Vice-Presi- 
dents . 

Dr." H. W. DESAUSSURE, of S. C, Dr. ISAAC HAYS, Secretaries. 

Dr. P. C. GOOCH, Treasurer. 

On motion of Dr. La Roche, of Penn., the Report was accepted, and 
the gentlemen thus nominated were declared the officers of the Associa- 
tion for the ensuing year. 

This motion was adopted, and the officers were invited to take their 
seats. 

The President elect then took the chair, and, in a few appropriate re- 
marks, returned his thanks for the honor thus conferred on him by the 
Association. 

On motion of Dr. Gaillard, of South Carolina, the following resolu- 
tion, offered by Dr. Drake, of Cincinnati, at the Session of 1850, were 
taken up for consideration : — 

Resolved, That the second section of the Regulations of the Associa- 
tion be so amended as to require that candidates for membership by in- 
vitation be nominated in writing by five members ; that, when elected, 
they shall enjoy all the rights of delegates, and that all permanent mem- 
bers shall be entitled to vote. 

After some discussion, on motion of Dr. A. H. Stevens, of New York, 
the resolution was referred to a committee, consisting of Drs. Drake, 
of Ohio, Wood, of Penn., and Wellford, of Virginia. 

On motion, the Association adjourned to meet to-morrow morning at 
10 o'clock. 

Morning Session. May 7. 

The Convention met this forenoon pursuant to adjournment, the 
President in the chair. 

The minutes of the previous meeting were read and confirmed. 

Dr. Wood asked and obtained leave to read the following report, on 
amending the Constitution, on behalf of himself and Dr. B. R. Well- 
ford. 

The committee to whom was referred the proposition of Dr. Drake, 



TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 263 

for an alteration in the rules in relation to the admission and rights of 
members, have the honor to report as follows :— 

There are two distinct branches of the proposition : the first of which 
relates to the invitation of medical men, not delegates, to participate in 
the proceedings of the Association ; the second has in view the exten- 
sion of the right of voting to permanent members. 

The committee agree in the general purport of the first part of the 
proposition. As it now stands, the rule admits of a too easy admis- 
sion to the privileges of members, and it is susceptible of great abuse. 
It might happen, in a place where the number of resident physicians 
was very considerable, that sufficient might be introduced to control 
the decisions of the delegates. To guard against such a result, the 
committee recommend, that, in addition to the provision that none 
should be invited by the Association, unless upon a previous written 
proposal by five delegates, the existing rule should be so altered as not 
to confer upon the invited members the privilege of voting. 

In relation to the second part of the proposition, that, namely, which 
gives the privilege of voting to permanent members, the committee do 
not consider its adoption advisable, on the following grounds : This 
Association is essentially a representative body. Its opinions are sup- 
posed to be those of the societies or associations by which the delegates 
are appointed, and go forth to the world with the authority in some 
degree of the medical profession generally. Now, if permanent mem- 
bers were permitted to vote, they would express their own individual 
opinions, and support their own individual preferences ; both of which 
might be in direct opposition to those of the delegates, and not fairly 
representative of general medical sentiment. It is easy to conceive, 
that combinations among permanent members might be formed, more 
powerful than the properly delegated body, which might thus be over- 
ruled in its decisions. The opinions or wishes of a comparatively few 
individuals might thus go forth to the world as those of the profession 
at large ; and private purposes might be answered at the expense of the 
general good. This would defeat the main objects of the Association, 
and prevent it from continuing, what it may now be considered to be, 
the exponent of enlightened medical sentiment in this country. 

The committee, therefore, recommend that the question on Dr. Drake's 
proposition be taken separately upon its two branches ; that the first 
be adopted with a modification, withholding the right of voting from 
invited members : and that the second, which confers this right upon 
permanent members, be not adopted. 

GEO. B. WOOD. 
B. R. WELLFORD. 

Charleston (S. C), May 7, 1851. 

Dr. Drake then read the subjoined minority report: — 
The undersigned, a minority of the committee, to whom was referred 
the resolution for amending the second section of the Constitution, begs 
leave to report that, in his opinion, it is expedient, and will be found 
promotive of the great objects for which the Association was formed, 
that " members by invitation" should not be admitted, except under a 
written nomination by five members ; that, when thus chosen, they 
should enjoy all the rights and privileges of delegates, including per- 
manent membership ; and that all permanent members should be en- 
titled to vote. With these views the undersigned respectfully submits 
a revision of the resolution into the following: — 



264 TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 

Resolved, That members by invitation shall be nominated, in writing, 
by five members, which nomination shall be made a matter of record ; 
that when elected they shall enjoy the rights and privileges of delegates, 
and remain as permanent members of the Association. 

Resolved, That all permanent members shall have the right of vot- 
ing. 

Respectfully submitted, 

DAN. DRAKE. 

Dr. I. Hats moved to take up the majority report, which motion was 
carried. 

Dr. Arnold spoke against the article of the Constitution, authorizing 
invited members to vote. 
Dr. Wood explained his report, and urged its adoption. 
Dr. Davis, of Chicago, said that there was much misunderstanding 
in regard to the intention of the Constitution in respect to the members 
by invitation. He hoped that the Constitution would be strictly acted 
up to, and that members should be invited only " from sections not 
otherwise represented." 

Dr. Wood said his was an amendment, and not a repeal of the old 
provision. 

Dr. Drake responded. He had waited for arguments against his 
resolution, but had heard none. He then entered into a long argument 
in favor of popularizing the Association with the profession in the United 
States, and took ground in favor of a permanent place of meeting at 
Washington City. 

Dr. W. Atlee, of Lancaster, said he could see no harm in giving the 
privilege of voting to invited members who came from unrepresented 
localities, but was opposed to the right of voting proposed to be given 
to permanent members. 

Dr. Meigs, of Philadelphia, asked whether a gentleman would be in- 
vited to attend without any privileges, and went on to say that he hoped 
the Convention would have five, ten, or even twenty thousand in attend- 
ance at some future period. 

Dr. Hooker, of Connecticut, begged to be allowed to offer the follow- 
ing resolution, the resolution of Dr. Drake having been laid on the 
table for the present : — 

Resolved, That no member be permitted to speak longer than ten 
minutes at one time in any one debate. 

Dr. Philips, of New York, offered to amend the resolution by insert- 
ing " fifteen," which motion was lost. 

The resolution, as offered by Dr. Hooker, was then adopted. 
Dr. Hays moved to lay the subject on the table, and added that by a 
constitutional provision it was required to lay over one year. 
The motion was seconded by Dr. Tucker, of Virginia. 
Dr. Dickson, of South Carolina, asked if the motion swept off the 
whole resolution, and was answered affirmatively by Dr. Hays. 

Dr. said, if the matter was postponed now they would not 

be out of difficulty, because all that is necessary to defeat it next year 
would be to move to amend it, and it would have to lay over a year 
again, &c. 

The matter was finally laid on the table. 

Dr. Wood, of Pennsylvania, called up the second part, or that portion 
giving to permanent members the right to vote. 

The majority committee accepted the substitute of the minority 
committee, which was read as follows, viz : — 



TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 265 

Resolved, That all permanent members shall have the right of voting. 

Dr. Dickson urged the adoption of the above resolution. 

Dr. Hays, of Philadelphia, remarked that the Constitution had not 
been studied by the gentleman who had urged the adoption of the reso- 
lution ; and spoke in opposition to the measure. 

Dr. Thompson, of Delaware, supported Dr. Hays, and hoped that the 
whole matter would be laid over for a year. 

Dr. Dickson observed that he had been accused of ignorance of the 
Constitution. He hoped to have these gentlemen always here to in- 
struct him. 

Dr. Bond, of Maryland, took part in the discussion. 

Dr. Adams, of Massachusetts, remarked that they ought to strike out 
the words "Permanent Delegates" from the Constitution, and was 
proceeding with his remarks, when the gentleman was called to order. 

The question was here taken on the adoption of the resolution, which 
was lost by a large majority. 

Dr. I. Hays, the Treasurer of the Association, then read the Report 
of the Committee of Publication, and also the Report of the Treasurer. 

The subjoined resolutions, appended, were read and adopted: — 

1. Resolved, That the assessment for the present year shall be three 
dollars. 

2. Resolved, That those delegates who pay the assessments shall be 
entitled to one copy of the Transactions for the present year ; and that 
the payment of two dollars, in addition, shall entitle them to two addi- 
tional copies. 

3. Resolved, That permanent members shall be entitled to one copy of 
the Transactions for the present year on the payment of two dollars, and 
three copies on the payment of five dollars. 

4. Resolved, That societies which have been represented in the Asso- 
ciation shall be entitled to copies for their members on the same terms 
that copies are furnished to permanent members. 

5. Resolved, That permanent members, unless present at the meeting 
as delegates, shall not be subject to any assessment. 

6. Resolved, That any delegate who is in arrears for his annual as- 
sessment shall not be considered as a permanent member. 

7. Resolved, That the several committees be requested to bring to the 
meeting of the Association, their reports, correctly and legibly trans- 
cribed ; and that they be required to hand them to the Secretaries as 
soon as they have been read. 

All which is respectfully submitted. 

ISAAC HAYS. 

D. FRANCIS CONDIE. 
Philadelphia, April 20, 1851. 

Dr. Drake, of Ohio, moved that the Report on Surgery be read first. 
Adopted. 

Professor Eve, Chairman of Committee on Surgery, then proceeded 
to read his report. 

A motion was made by Dr. Davis to commit the same to the Com- 
mittee on Publication ; which was adopted. 

Dr. Hays moved to read Dr. Flint's Report by its title — Practical 
Medicine — and refer the same to the Committee on Publication, which 
motion was adopted ; and several hundred copies, printed and furnished 
by the author, were directed to be distributed. 

A motion was then made to adjourn till 5 o'clock, P. M., which was 
adopted, and the Convention adjourned. 



266 TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 



Afternoon Session. 

The President having organized the meeting, 

Dr. Boyle, of "Washington, offered a resolution that the Association 
in future meet at Washington City. 

Dr. C. P. Johnson, of the Virginia Medical Society, extended an in- 
vitation to meet at Richmond ; Dr. Jones, of the University of Louisiana, 
to meet in New Orleans ; Dr. J. P. Johnson, of Missouri, to meet in 
St. Louis. The resolution and invitations were referred to the Com- 
mittee on Nominations. 

The President suggested to the Society the propriety of appointing 
the standing committees at an early period. 

Dr. Wood remarked that there was a proposition to abolish standing 
committees. 

Dr. Hats said he was opposed to these committees, but would not 
press an alteration. 

Dr. Tucker moved that the appointment of the standing committees 
be referred to the Committee on Nominations, which motion was adopted. 

Dr. Jones, of Louisiana, resigned as a member of the Committee on 
Nominations ; and Dr. Fenner, of New Orleans, was appointed in his 
place. 

Dr. Parsons then moved that the Committee on Nominations be re- 
quested to resume its labors, which was adopted. 

Dr. AYragg, of Charleston, moved that the Report of the Committee 
on Prize Essays be read, and then that the Obstetric Report be brought 

The Report on Prize Essays was then read, and certain resolutions 
appended thereto were adopted.* 

When, on motion of Dr. Ready, of South Carolina, the whole matter 
was referred to the Committee on Publication. 

Dr. Storer, of Boston, Chairman of the Committee on Obstetrics, read 
the report on that subject. He stated that he had received a letter from 
Dr. Thompson, of Illinois — that he was the only member of the com- 
mittee who had aided him in any degree. He mentioned this fact be- 
cause he had to hold himself entirely responsible for all the inaccura- 
cies, &c. 

Dr. Phelps, of New York, moved that the report be referred to the 
Committee on Publication. 

Dr. Robertson, of South Carolina, moved that the statistics, alluded 
to in the report, be stricken out, as the author was not a reliable man. 

Dr. Storer seconded the motion. 

Dr. Bond moved to postpone the report until morning, which was 
seconded by Dr. Gilman. 

A short debate here ensued ; when it was finally agreed to re-commit 
said portion of the report to be corrected, and laid before the Association 
in the morning. 

On motion, the Convention adjourned to meet to-morrow morning. 

Morning Session. May 8. 

The President, Dr. James Moultrie, in the chair. 
The minutes of the previous meeting were read, and after some slight 
amendments were confirmed. 

* We understand that a prize was awarded to Dr. Dalton, of Boston, for an essay 
on the " Corpus Luteum." — Ed. 



TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 267 

Dr. J. M. Smith, of Mass., moved that the Report of the Committee 
on Medical Education be made the special order, after the disposal of 
the Report of the Committee on Obstetrics. 

Dr. Gail lard, on behalf of the Committee of Arrangements, read a 
list of delegates reported as registered since the last report. 

Dr. Campbell, of Georgia, presented a model of a malformation of the 
knee-joint, the patella being absent. 

Dr. AVood, of Penn., offered the following resolution: — 

Resolved, That Colleges exclusively of Dentistry and Pharmacy are 
not recognized, by the Association, as among the bodies authorized to 
send delegates to its meetings. 

Dr. Wood, of New York, moved to amend, by dividing the resolution, 
so as to take the question, first, on the reception of delegates from Col- 
leges of Dentistry ; secondly, on the reception of delegates from Colleges 
of Pharmacy. 

The amendment having been accepted, the question of the reception 
of delegates from Colleges of Dentistry was debated. 

Dr. Lamb moved an indefinite postponement of the resolution, which 
was lost. 

Dr. Yardley, of Pennsylvania, asked and obtained leave to read the 
subjoined resolution, presented by the Philadelphia Co. Medical Society. 

Resolved, That all the Medical Colleges in the United States are here- 
by earnestly and respectfully requested to hold a convention, through 
delegates respectively chosen by them at least once in every six years, 
to take into consideration the proper method of harmoniously elevating 
the standard of Medical Education in the said Colleges. 

The discussion of the original question was then resumed. 

A motion was finally made by Dr. Hays, of Pennsylvania, that the 
whole resolution of Dr. Wood, including Colleges of Dentistry and Phar- 
macy, be referred to a special committee of five members, which resolu- 
tion was adopted. 

On motion of Dr. Yardley, of Pennsylvania, the resolution presented 
by the Philadelphia County Medical Society was also sent to the same 
committee. 

Dr. Jones, of North Carolina, offered the following resolution : — 

Resolved, That all the Medical Colleges in the United States are here- 
by earnestly and respectfully requested to hold a convention, through 
delegates respectively chosen by them, at least once in every six years, 
to take into consideration the proper method of harmoniously elevating 
the standard of Medical Education in the said Colleges. 

The order of the day was then called up, when Dr. Storer reported 
that he erased the statistics referred to yesterday, and that he placed 
the report in the hands of the Association. Dr. S. said that there was 
objection to the remarks on the subject of Dr. Gilman's paper on the 
speculum. He asked that he be permitted to remove the unnecessary 
expression of opinion in regard to that subject. He further added that 
he had taken from the journals these facts, &c, and was not therefore 
responsible for the correctness of the papers, &c. 

Dr. Bond, of Md., remarked that there were charges in these reports 
which he did not individually endorse ; but which, go out in a book 
under the sanction of the Association. 

On motion of Dr. Davis, the report was referred to the Committee on 
Publication. 

At this stage of the proceedings, Professor S. S. Haldeman, of Lan- 
caster city, Pennsylvania, through Dr. John L. Atlee, presented to the 



268 TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 

Association an Essay on Latin Pronunciation, of which he is the author; 
and which, on motion of Dr. Atlee, was referred to the Committee on 
Medical Literature. 

On motion, the regular order was suspended for the reception of the 
Eeport of the Committee on Nominations, which was read and laid on 
the table. 

Dr. Hays then called up the resolution on page 43, vol. ii. of the 
Transactions of the Association, and moved to strike out " all that relates 
to committees," &c. 

The motion was seconded by Dr. Stevens, and urged by Dr. Drake, 
who read some ten or twelve special points, which, he said, ought to occu- 
py the Association instead of being occupied with epitomes of Ranking 
and Braithwaite. 

Dr. Hooker, of Conn., spoke of the looseness of committees and edit- 
ors of the Journals. 

Dr. Davis thought that they could decide on the matter at once. 

Dr. Hays proposed to dispense with the Standing Committees. The 
question was then taken on the resolution, which was adopted. 

Dr. Wood, of Penn., offered the following resolution, which was 
adopted : — 

Resolved, That a committee be appointed to take into consideration 
the arrangement of a committee for future action, to report as speedily 
as possible. 

The Chairman of the Committee on Medical Education was about to 
read the regular report on that subject, when Dr. Drake moved the 
suspension of the reading till after the recess, as it was a very long re- 
port. 

On motion of Dr. Johnston, of Missouri, the Report of the Committee 
on Medical Literature was then taken up. 

Dr. Desaussure announced that Dr. Davis would read a paper entitled 
an Experimental Inquiry concerning some points connected with the 
process of Assimilation and Nutrition. 

Dr. Reyburn, of Missouri, presented and read the Report of the Com- 
mittee on Medical Literature. In the course of his reading the report, 
he gave way to a motion to adjourn. 

Afternoon Session. 

The President took the chair at half-past 5 o'clock and organized the 
meeting. 

The Secretary announced the following gentlemen as having been 
appointed by the President, under resolution of this morning, concern- 
ing a Committee for the Arrangement of Business, for the occupation of 
the Association in future : Drs. G. B. Wood, of Pennsylvania ; Dr. I. Hays, 
D. Drake, A. H. Stevens, W. Hooker, B. R. Wellford, and S. H. 
Dickson. 

The following gentlemen were appointed a committee under a resolution 
in regard to Schools of Pharmacy and Dental Surgery, viz : Drs. Hays, 
Stevens, Yardley, Storer, and Jones. 

Dr. Dickson moved the following preamble and resolutions, which 
were seconded by Dr. Bond, and unanimously adopted without debate: — 

Whereas, efforts are being made to repeal the law of 1847, which con- 
fers protective rank on the members of the Medical Department of the 
Army, therefore 

Resolved, That the American Medical Association views, with regret, 
the existence of hostility to the act of Congress, approved February 11, 



TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 269 

1847, which confers legal rights, and equality with other staff depart- 
ments, on the medical officers of the army, and gives them a position to 
which the importance and character of the profession entitle them. 

Resolved, That copies of these resolutions, with the resolutions of the 
Association passed at its last annual meeting, on the same subject, be 
transmitted to the Secretaries of War and of the Navy, through the 
Chiefs of the Medical Department of each service, and to the presiding 
officers of the Senate and House of Representatives of the United States. 

The reading of the Report of the Committee of Medical Literature was 
then concluded. 

On motion, the report was adopted, and referred to the Committee on 
Publication. 

The Report of the Committee on Medical Education was then called for, 
and as the hour was late, the chairman read only so much of it as relates 
to Demonstrative Midwifery, which had by special resolution been re- 
ferred to the committee. 

On motion, the report was accepted, and referred to the Committee 
on Publication. 

Dr. Dickson then offered the following resolution, which was adopted: 

Resolved, That this Association unanimously approve of the opinions 
expressed in the Report of the Committee on Medical Education in re- 
spect to Demonstrative Midwifery.* 

The Convention then adjourned to meet to-morrow morning at 10 
o'clock. 

Morning Session. May 9. 

The President, Dr. James Moultrie, in the chair. 

The minutes of the last meeting were read and confirmed. 

The Report of the Committee on Medical Education being the special 
order, Dr. Stevens, of New York, asked and obtained leave to introduce 
the following resolutions : — 

Resolved, That the members of this Association cannot separate with- 
out expressing their grateful sense of the hospitalities, and numerous 
delicate attentions, received from their medical brethren of South Caro- 
lina, and the citizens of Charleston. 

Resolved, That a committee be formed, to procure a tablet with a 
suitable inscription, commemorative of this meeting, and the feeling it 
has elicited, to be placed at the disposal of the Medical Association of 
South Carolina. The inscription to be as follows : — 

"This tablet is here placed by the American Medical Association, to 
commemorate their annual meeting in the city of Charleston, in May, 
1851, and to signalize their gratitude for the extraordinary professional 
and social enjoyments that accompanied it." 

The resolutions having been seconded were adopted, and Dr. Stevens 
further moved that Drs. Hayward, of Mass., and F. A. Ramsey, of Tenn., 
and himself constitute the committee. 

Dr. Ramsey, of Tenn., asked and obtained leave to read a letter from 
Dr. E. D. Fenner, of Louisiana, and offered the following resolution on 
the subject, which was adopted: — 

Resolved, That the efforts of Dr. Fenner to place, on a firm and dura- 
ble basis, an annual publication, embracing medical reports, from the 
whole Southern portion of the Union, merits the commendation of this 
Association, and should receive solid support from American physicians. 

* We understand that Demonstrative Midwifery was unqualifiedly condemBed 
by the Association. — Ed. 



270 TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 

Dr. Hats, of Pa., asked and obtained leave to call up for consideration 
so much of the report of the Nominating Committee as relates to the 
selection of the next place of meeting of the Association, and the appoint- 
ment of the Committee of Arrangements and the Committee on Publica- 
tion, and other standing committees, having been abolished. The report 
having been read, Dr. Drake, of Ohio, made an urgent appeal in favor 
of Washington City as the next place of meeting. The question being 
taken on the adoption of that part of the report of the committee which 
proposed Richmond (Va.) as the next place of meeting, it was adopted 
by a large majority. The question being taken on the confirmation of 
the Committee of Arrangements and Publication, the nominations of the 
committee were confirmed. 

Richmond, Va., was selected as the next place of meeting by the Asso- 
ciation, and the following gentlemen appointed a Committee of Arrange- 
ments, viz : Drs. R. W. Haxall, chairman ; Carter P. Johnson, James 
Beale, Chas. B. Gibson, S. Manpas, R. D. Haskins, C. S. Mills, and 
M. P. Scott. Committee on Publication — Drs. Hats, of Pa., G. Emer- 
son, of Pa., D. F. Condie, of Penn., H. W. Desaitssure, of S. C, I. 
Parrish, of Penn., P. C. Gooch, of Va., and G. W. Norris, of Penn. 

Dr. Hooker, of Conn., Chairman of the Committee on Medical Educa- 
tion, completed the reading of the report of the committee, and offered 
the following resolutions: — 

Resolved, That the abuses which exist in the modes of medical edu- 
cation pursued in this country demand the serious consideration of the 
profession. 

Resolved, That free discussion in relation to these causes is an im- 
portant means of effecting their removal. 

Resolved, That in the opinion of this Association no effort to remove 
these abuses can succeed, that is not based upon a reform in the public 
sentiment, both of the profession and of the community. 

Resolved, That this reform, so far as the profession is concerned, is to be 
effected mainly through its organization, and that it is therefore incum- 
bent upon every physician to do all that he can to give them character 
and efficiency. 

Resolved, That this Association have confidence in all proper efforts 
which have for their object a reform in the sentiments and practice of 
the community in relation to medicine and the medical profession. 

Resolved, That the recommendations of this Association at its former 
meetings in regard to education, both preliminary and medical, be re- 
affirmed, and that both the schools and private preceptors be still urged 
so to do their duty as to secure to the community a well-educated pro- 
fession. 

Resolved, That in the work of medical reform, while all precipitate 
movements should be avoided, we should aim at a steady advance, from 
year to year, till a thorough system of education be established by the 
profession throughout our country. 

Dr. Wood, of Pennsylvania, asked leave to suspend the order usually 
taken with reports. Permission being granted, he read the following 
report, which was adopted : — 

The committee to whom was referred the subject of arranging a plan 
of committees, for future action, in place of the standing committees, 
abolished by the Association, have the honor to report as follows : 

It appears to them that the most feasible plan of accomplishing tho 
objects of the Association is to select certain subjects, which may bo 



TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 271 

considered as suitable for investigation, and to refer these subjects to 
special committees, to be appointed before the close of the present ses- 
sion, and to report to the next. Such a selection the committee have 
accordingly made, and will offer to the consideration of the Association. 

As an additional means of securing valuable contributions, they pro- 
pose, also, the appointment of a committee, whose business it shall be, 
in the interval between this and tho next session, to receive original 
volunteer papers upon any subject which their authors may choose ; to 
decide upon the merits of these papers ; and to present to the Associa- 
tion, at its next session, such of them as they may deem worthy of re- 
ceiving this distinction. With a view to increase competition, they think 
it advisable, that a prize of fifty dollars, or a gold medal of that value, 
be awarded to each of the five papers presented to the Association, or 
any smaller number of them, which tho committee may consider most 
meritorious, and the Association may resolve to publish. 

In reference to the resolution presented in the lleport of the Standing 
Committee on Medical Literature, and referred to the present committee, 
they have only to observe that, as its ends will probably be most effect- 
ively obtained by the adoption of tho general plan which they have 
already brought before the notice of tho Association, they do not con- 
sider it expedient to make any further report. 

As to the appointment of the special committees referred to, your 
committee think that the most convenient plan will bo to refer to a spe- 
cial committee the nomination of a chairman for each, who shall then 
select at his convenience, two individuals, to aid him, with the restric- 
tion only, that the persons so selected shall be members of the Asso- 
ciation. 

To the same nominating committee may bo referred the appointment 
of the general committee, whose business will be to receive and judge 
[of the merits of] whatever papers [are submitted to them]. As the 
members of this general committee must frequently compare opinions, 
it will be desirable that they should reside near each other ; and it is 
accordingly proposed that they should be chosen from one neighbor- 
hood. If the plan be found to work well, this locality may be changed 
every year, so that each section of tho Union may, in its turn, be 
charged with this duty. Tho committee would suggest that the general 
committee should bo first chosen from members of the Association re- 
siding in Boston or its neighborhood, as the most northern point. 

To embody these suggestions in due form, the committee offer the 
following resolutions : — 

I. Resolved, That committees of three be appointed to investigate and 
report severally on the following subjects : — ■ 

1st. Causes of the tubercular diathesis. 

2d. Blending and conversion of the types of fever. 

3d. The mutual relations of yellow fever and bilious remittent 
fever. 

4th. Epidemic erysipelas. 

5th. Acute and chronic diseases of the neck and of the uterus. 

Gth. Dengue. 

7th. The milk sickness, so called. 

8th. Endemic prevalence of tetanus. 

9th. Diseases of parasitic origin. 

10th. Physiological peculiarities and diseases of negroes. 

11th. The action of water on lead pipes and the diseases which pro- 
ceed from it. 



272 TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 

12th. The alkaloids which may be substituted for quinia. 

13th. Permanent cure of reducible hernia. 

14th. Results of surgical operations for the relief of malignant dis- 
eases. 

15th. Statistics of operations for removal of stone in the bladder. 

16th. Cold water dressings. 

17th. The sanatary principles applicable to the construction of dwell- 
ings. 

18th. The toxicological and medicinal properties of our cryptogamic 
plants. 

19th. Agency of the refrigeration produced through upward radia- 
tion of heat as an exciting cause of disease. 

20th. Epidemic diseases of New England and New York. 

21st. Epidemic diseases of Pennsylvania, New Jersey, Delaware, and 
Maryland. 

22d. Epidemic diseases of Virginia and North Carolina. 

23d. Epidemic diseases of South Carolina, Georgia, Florida, and 
Alabama. 

24th. Epidemic diseases of Mississippi, Louisiana, Texas, and Arkan- 
sas. 

25th. Epidemic diseases of Tennessee and Kentucky. 

26th. Epidemic diseases of Missouri, Illinois, Iowa, and Wisconsin. 

27th. Epidemic diseases of Indiana, Ohio, and Michigan. 

II. Resolved, That a Committee on Nominations be appointed, whose 
duty it shall be to nominate one chairman for each of the above com- 
mittees. 

III. Resolved, That each of the chairmen thus nominated shall select, 
at his earliest convenience, [two] members of the Association to complete 
the committee. 

IV. Resolved, That a committee of five members be appointed, to be 
called the Committee for Volunteer Communications, whose duty it shall 
be, in the interval between the present and the next succeeding sessions, 
to receive papers upon any subject from any persons who may choose to 
send them, to decide upon the merits of these papers, and to select for 
presentation to the Association, at its next session, such as they may 
deem worthy of being thus presented. 

V. Resolved, That the Committee for Volunteer Communications shall 
have the power to form such regulations as to the mode in which the 
papers are to be presented, and as to the observing of secrecy, or other- 
wise, as they may think proper. 

VI. Resolved, That the selection of the members of this committee 
be referred to the same Nominating Committee, whose duty it will be to 
appoint the chairman of the several special committees, as above di- 
rected ; with this restriction, that the individuals composing it shall 
reside in the same neighborhood. 

VII. Resolved, That a prize of fifty dollars be awarded to each of the 
volunteer communications reported on favorably by the committee, and 
directed by the Association to be published : Provided that the number 
to which the prize is thus awarded do not exceed five ; and provided, 
also, if the number approved and directed to be published exceed five, 
that in such case the prize be awarded to the five which the committee 
may determine to be most meritorious. All of which is respectfully 
submitted. GEO. B. WOOD, Chairman. 

Charleston, May 9th, 1851. 



TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 273 

Dr. Hays, of Penn., gave notice, that at the next meeting of the As- 
sociation, he should offer an amendment to the Constitution, line 4, so 
as to read $10 instead of $3. 

Dr. Atlee, of Pennsylvania, remarked on the value of the Keport of 
the Committee on Medical Education, and offered the following resolu- 
tion, which was adopted : — 

Resolved, That it be recommended to the several State Medical Socie- 
ties throughout the Union, to procure a republication of the Report of 
the Committee on Medical Education, for general distribution among 
the profession. 

Dr. Drake offered the following resolution : — 

Resolved, That, in the opinion of the Association, the students of our 
schools should be required to matriculate within the first days after the 
opening of the sessions, and continue their attendance to the end of the 
terms, taking with them evidence of the same, to be presented with 
tickets of the professors when they become candidates for degrees. 

The resolution was adopted, and Dr. Gibson moved to defer the filling 
up of the blank. Some discussion arose on this point, when the reso- 
lution was left to read " within the first days/ 7 &c. 

The Report of the Committee on Medical Science was then called up, 
when a letter was read from Dr. Dowler, chairman of said committee, 
regretting his inability to be present, and the necessity of sending it. 

Dr. Fenner then read the outlines of the report, and asked permission 
to retain the same for revision, copying, &c, which was granted. 

Dr. Mauran offered the following resolution, which was adopted : — 

Resolved, That the Committee on Publication be instructed to print 
conspicuously upon the title-page of the forthcoming volume o the 
Transactions the following declaration, viz: "The American Medical 
Association, although formally accepting and publishing the reports of 
the various standing committees, holds itself wholly irresponsible for 
the opinions, theories, or criticisms, therein contained." 

Dr. Storer moved the following resolution, which was adopted : — 

Resolved, That the hearty thanks of this Association be presented to 
their late secretary, Alfred Stille, M. D., for his constant, unwearied, 
and invaluable services since its first organization. 

The Report of the Committee on Adulterated Drugs was read. A motion 
was made to refer the same to the Committee on Publication, which was 
lost, and a motion to lay it on the table adopted. 

Dr. Gaillard, of South Carolina, Chairman of the Committee on Hygi- 
ene, presented an outline of the report on that subject. Referred to the 
Committee on Publication, with authority to append thereto a paper, now 
in preparation, on the mortuary statistics of certain cities. 

Dr. Drake, of Ohio, offered the following amendments to the Consti- 
tution, which were read, and ordered to lie over under the rule : — 

All members by invitation must be nominated in writing by five 
members of the Association, whose names shall be recorded in the 
minutes. When elected, they shall enjoy all the rights and privileges 
of delegates, and remain permanent members of the Association. 

All permanent members shall be entitled to vote, and when they 
attend a meeting of the Association, their respective names shall be 
registered, and each shall pay the sum required from a delegate. 

The Secretary read a protest from the Iowa University against the 
representation of Rush Medical College in this Association. 

Dr. Jervey moved to refer the protest to a special committee, to 
report at once. 



274 TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 

Dr. "Wood moved to refer it to the Committee on Colleges of Pharmacy 
and Dentistry, which was carried ; Dr. Jervey withdrawing his motion. 

Dr. Wood read the following report of Committee on Nominations, 
which was adopted : — 

The committee to whom was referred the nomination of the chairmen 
of the several special committees, to report at the next session, and 
also of the Committee for Volunteer Communications, report that they 
have fulfilled the object of their appointment, and offer the following 
list of chairmen to the committees first referred to, viz : — 

1st. Dr. D. F. Condie, Philadelphia, chairman to the committee on 
the causes of the tubercular diathesis. 

2d. Dr. S. H. Dickson, of Charleston, S. C, on the blending and 
conversion of the types of fever. 

3d. Dr. James Jones, of New Orleans, on the mutual relations of 
yellow and bilious remittent fever. 

4th. Dr. John B.Johnson, of St. Louis, Mo., on epidemic erysipelas. 

5th. Dr. Charles D. Meigs, of Philadelphia, acute and chronic diseases 
of the neck of the uterus. 

6th. Dr. J. P. Jervey, of Charleston, S. C, on Dengue. 

7th. Dr. Daniel Drake, of Cincinnati, milk sickness — so called. 

8th. Dr. Lopez, of Mobile, Alabama, endemic prevalence of tetanus. 

9th. Dr. Geo. B. Wood, of Philadelphia, on diseases of parasitic 
origin. 

10th. Dr. R. D. Arnold, of Savannah, Geo., on the physiological pe- 
culiarities and diseases of negroes. 

11th. Dr. Horatio Adams, of Waltham, Mass., on the action of water 
on lead pipes, and the diseases which proceed from it. 

12th. Dr. Jos. Carson, Philadelphia, on the alkaloids which may be 
substituted for quinia. 

13th. Dr. Geo. Hayward, Boston, Massachusetts, on the permanent 
cure of reducible hernia. 

14th. Dr. S. D. Gross, Louisville, Kentucky, on results of surgical 
operations for the relief of malignant diseases. 

15th. Dr. James R. Wood, New York, Statistics of the operation for 
the removal of stone in the bladder. 

16th. Dr. Charles A. Pope, St. Louis, Missouri, Water, its topical uses 
in surgery. 

17th. Dr. Alex. H. Stevens, New York, Sanatary principles applicable 
to the construction of dwellings. 

18th. Dr. Porcher, Charleston, South Carolina, Toxicological and me- 
dicinal properties of our cryptogamic plants. 

19th. Dr. G. Emerson, Philadelphia, Agency of the refrigeration pro- 
duced through upward radiation of heat as an exciting cause of dis- 
ease. 

20th. Dr. Worthington Hooker, Connecticut, on the epidemics of New 
England and New York. 

21st. Dr. John L. Atlee, of Lancaster, Penn., on the epidemics of New 
Jersey, Pennsylvania, Delaware, and Maryland. 

22d. Dr. Robert W. Haxall, Richmond, Va., on the epidemics of Vir- 
ginia and North Carolina. 

23d. Dr. Wm. M. Boling, Montgomery, Ala., on the epidemics of South 
Carolina, Georgia, Florida, and Alabama. 

24th. Dr. Ed. II. Barton, Louisiana, on the epidemics of Mississippi, 
Louisiana, Texas, and Arkansas. 



TEANSACTIONS OF AMERICAN MEDICAL ASSOCIATION". 275 

25th. Dr. Sutton, Georgetown, Ky., on the epidemics of Tennessee 
and Kentucky. 

26th. Dr. Thos. Reyburn, Missouri, on the epidemics of Missouri, Illi- 
nois, Iowa, and Wisconsin. 

27th. Dr. Geo. Mendenhall, Ohio, on the epidemics of Ohio, Indiana, 
and Michigan. 

The following gentlemen were appointed on the Committee for Vol- 
unteer Communications, viz : Drs. Geo. Hayward, J. B. Jackson, D. 
H. Storer, and Jacob Bigelow, of Boston, and Dr. Usher Parsons, of Pro- 
vidence, R. I. 

Signed on behalf of the Committee, 

GEO. B. WOOD, Chairman. 

Charleston, Friday, May 9th, 1851. 

The President read an invitation from the Committee of Reception 
to a steamboat excursion on the Cooper and Ashley Rivers. 

Dr. M'Intyre, of New York, proposed that the Code of Ethics and 
Constitution of the Association be recommended to be published by the 
several State Societies. Proposition adopted. 

Dr. Grimshaw offered the following resolution : — 

Resolved, That Medical Colleges, in publishing statements of the 
number of medical and surgical cases treated at their dispensaries, act 
contrary to the spirit of the Code of Ethics adopted by this body. 

Adjourned. 

Afternoon Session. 

The Association re-assembled at 5 o'clock, Dr. B. R. Wellford, of 
Virginia, Vice-President, in the chair. 

The special order was called for, and Dr. Davis, of 111., read a paper 
on the Influence of Certain Diet on the Functions of Respiration and 
Calorification, &c. 

The President, Dr. James Moultrie, resumed the chair. 

Dr. Hays moved to proceed with the consideration of unfinished busi- 
ness. 

Dr. Grimshaw offered the subjoined resolution, which was adopted : — 

Resolved, That the thanks of the Association be returned to Dr. Davis 
for the paper just presented by him. 

Dr. F. A. Ramsey, of Tenn., called up, as unfinished business, the 
resolution offered yesterday by Dr. Jones, of Tenn., and not then acted 
upon, to which Dr. Grimshaw offered the following amendment — " And 
that the first Convention be held before the first of May, 1852." The 
question being taken on the resolution and the amendment, they were 
both negatived by a large majority. 

Dr. Phelps, of New York, offered the following resolutions, which 
were unanimously adopted : — 

Resolved, That the warmest thanks of the Association be tendered to 
the Trustees of the St. Andrew's Society for the gratuitous use of their 
very convenient and eligible hall ; and to all those other institutions 
and reading rooms which have been so freely thrown open for the in- 
spection and use of the members. 

Resolved, That the Committee of Arrangements receive our most grate- 
ful acknowledgments for the very handsome, and indeed magnificent 
manner in which they have provided for the entertainment and plea- 
sure of the delegates from abroad, during their sojourn in the city of 
Charleston. 



276 TRANSACTIONS OF AMERICAN MEDICAL ASSOCIATION. 

Resolved, That not only the profession of medicine, but also private 
munificence, and the kind attentions of the citizens generally, have con- 
spired in manifestation of that urbanity of manner, and that unwearied 
and kind attention, which commands not only our profound admiration, 
but will be followed by the most pleasing recollections so long as life 
and thought shall endure. 

On motion of Dr. Stevens, the above resolutions, with those 
offered by him at the morning session, were ordered to be published in 
the city papers. 

Dr. Johnston, of St. Louis, moved to adjourn sine die, which was 
adopted. 

The Vice President, Dr. Wellford, of Virginia, then congratulated 
the Association on the happy termination of its labors, and declared it 
adjourned, to meet again in Richmond, Va., on the first Tuesday in May 
next. 



Simple Cupping Instrument. — At a recent meeting of the Suffolk Dis- 
trict Medical Society, Dr. Gould exhibited a new instrument for cup- 
ping, formed of a thick, firm, hollow India rubber ball cut in half. In 
applying it, all that is necessary is to place the concave surface on the 
part to be cupped, and press down the centre to exhaust the air, after 
which the fingers may be taken off, and the ball will be found to adhere, 
and quite firmly, too, by means of the vacuum created. For all the or- 
dinary purposes of cupping, this simple contrivance will be found most 
effectual, and particularly in dry cupping. It has advantages over glass 
cups, either with or without the pump, and the cost of a dozen of them 
would not exceed a dollar ; besides, there can be no breakage, or liabil- 
ity to get out of order, nor is anything required to exhaust the air from 
them, save the pressure spoken of, when they are applied. To the country 
practitioner, who cannot always have leeches at his command, this sim- 
ple and cheap substitute will be most acceptable. — Boston Med. and 
Surg. Journ., April 9th, 1851. 



THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. IV. SEVENTH MONTH (JULY), 1851. No. 6. 

Cholera Infantum-— An Inquiry into its Nature. By A. 
Nebinger, Jr., M. D. 

The nature, the primary seat of the lesions existing in cho- 
lera infantum, have often been discussed by the writers and 
teachers of nosology-— some contending that the disease is 
primarily a g astro-enteric derangement, others that it is a 
hepatic gastro-enteric malady ; the liver being the organ ori- 
ginally involved, and the gastro-enteric phenomena and lesions 
the results, or secondary effects of the hepatic derangement. 
The question is not yet a settled one, as there are those who 
affirm or deny one or other of the above stated views. The 
question being still an open one, I purpose making a few ob- 
servations, and constructing a few arguments in regard to the 
nature of this interesting disease ; not, however, expecting to 
add anything very important to the general fund of informa- 
tion in relation to it ; but hoping, nevertheless, that the dim 
rays of my little rush-light may not be completely lost amid 
the brighter refulgence of the great luminaries of medicine. 

The anatomical lesions in cholera infantum, which present 
themselves upon a post-mortem examination, are such as indi- 
cate a derangement of the liver, stomach, and alimentary canal. 
The portal vessels have been found largely congested, and some 
researchers into morbid anatomy report cases where an en- 
largement of the liver existed. The gall-bladder in some 
instances has been found containing a large amount of thick, 
acrid, viscid secretion ; in other instances, it has been found 
quite empty. But not a single case has been reported by an 
undoubted investigator, where the gall cyst was found contain- 
vol. iv. — 23 



278 NEBINGER ON CHOLERA INFANTUM. 

ing a healthy or normal fluid. The gastric mucous mem- 
brane has been found inflamed, ulcerated, softened, and its 
follicles enlarged. The mucous membrane of the intestines 
has revealed inflammation and ulceration ; the glands, both 
solitary and agminate, enlarged. The mucous coat of the colon 
has evidenced inflammation and softening. Thus, then, we 
have an autopsy in a case of cholera infantum, revealing ex- 
tensive derangements of the liver, stomach, and bowels. Here 
naturally arise the questions: — Is Cholera Infantum primarily 
a disease of all these organs and tissues, or has it its origin in 
one only ? Does it at once leap forth into life a hepatic gastro- 
enteric disease, or is it originally or primarily confined to one 
of these organs, and gradually spreads itself to another and 
another, until the whole train or series of morbid conditions 
presented above become slowly developed? These questions 
have been variously, and I may say, in some instances, curi- 
ously answered. Dr. Gr. B. Wood says, " Cholera Infantum 
may be safely inferred to consist essentially in an irritation 
or inflammation of the alimentary mucous membrane, directed 
especially to the mucous follicles, and associated with a con- 
gested and torpid state of the liver, probably depending upon 
the same cause"* Dr. Robley Dunglison, in his article upon 
Cholera Infantum, published in " The Cyclopaedia of Practical 
Medicine, 1850," vol. i. p. 427, observes, that "the liver is 
almost always enlarged," and that "this has been regarded as 
the primary affection, but it is more probably secondary. 5 ' 
Dr. J. F. Meigs (Practical Treatise on the Diseases of Chil- 
dren, ed. 1848, p. 297) says, "I am disposed to believe that 
Cholera Infantum is a disease of the mucous membrane of the 
alimentary canal, which, beginning with morbid development 
of the mucous follicles or crypts, independent of evident inflam- 
mation, occasions first super-secretion from these organs, and, 
after a time, runs into inflammation and its results, ulceration, 
softening, and thickening." Dr. Condie (Diseases of Children, 
ed. 1850, p. 234) remarks, in regard to Cholera Infantum, 

* Treatise on the Practice of Medicine, by G. B. Wood, 1847, vol. i. 
p. 673. 



NEBINGER ON CHOLERA INFANTUM. 279 

that "comparing the symptoms during the lifetime of the pa- 
tient with the appearances discovered after death, it would 
appear to depend in its earlier stages upon hyperemia of the 
mucous membrane, with an augmentation of the size of, and 
activity of function of the muciparous follicles of the alimentary 
canal." Dr. Dewees regarded "the congestion of the portal 
vessels and the enlargement of the liver as secondary effects," 
depending for their origin upon the diseased alimentary mu- 
cous tissue. 

It is not necessary to further point out, or exhibit the various, 
somewhat discordant, and at best indefinite opinions enter- 
tained and promulgated by medical writers and teachers, in 
regard to the nature, primary seat, or starting point of mor- 
bific influences in this disease. More would only increase the 
confusion those already cited are well calculated, when taken 
en masse, to excite. 

Before proceeding further, I have to confess that I am not 
disposed to regard the gastro-enteric phenomena, which pre- 
sent themselves in this malady, as primary, but secondary 
manifestations of disease ; hence, that neither the stomach 
nor bowels is the organ originally involved. But I consider 
the liver to be the primary seat of morbific influences, and 
that from it are radiated the morbid conditions of the gastric 
and enteric mucous membranes ; the acute gastric and enteric 
derangements depending not only entirely for their origin, but 
mainly for their continuance, upon the diseased action of the 
great abdominal gland. 

I have now to solicit the reader's attention, whilst I endea- 
vour to present the facts and arguments upon which I base the 
above conclusion in regard to the nature of Cholera Infantum. 

The portal vessels, as has just been stated, are largely con- 
gested, the liver sometimes enlarged, the gall cyst contains in 
some instances, a dark, acrid, viscid secretion ; in other in- 
stances, it has been found nearly or quite empty ; but the fluid, 
when found, has always been abnormal. 

The season when this disease occurs is summer, and the 
cases are greater or smaller in number, and more or less grave, 



280 NEBINGER ON CHOLERA INFANTUM. 

as the heat of the season is exalted or depressed. July and 
August are the months which have the more exalted tempe- 
rature ; they are also the months when Cholera Infantum pre- 
vails most, and when the bills of mortalitv of our cities are 
much increased in their aggregate numerical amounts, by 
their records of the deaths produced by this destructive enemy 
of infancy. 

Hepatic derangements are emphatically the diseases of the 
tropics and warmer latitudes of the temperate climates. Nearly 
all the diseases of the tropics, and a large number of those of 
the warmer latitudes of the temperate zones, involving the 
alimentary canal, are complicated with hepatic derangements. 
Their diarrhoeas are not simple diarrhoeas, consisting in 
merely an irritation of, and hyper-secretion or effusion from, 
the mucous membrane of the intestines, but are generally 
bilious diarrhoeas. So of their dysenteries ; they are not simply 
such, but take upon themselves a bilious type. Now, the con- 
verse of all this is true of the enteric derangements of the 
colder latitudes ; they being almost universally exempt from 
hepatic complications. Hence I infer, and think the reader 
will conclude with me that the inference is perfectly legiti- 
mate, that heat, exalted atmospheric temperature, is the cause 
which predisposes to, and may excite in those of the tropics, 
&c, enteric diseases of a bilious type. This cause being ab- 
sent in the other, or colder latitudes, the complication, or if 
you like it better, this peculiar kind of dysentery and diarrhoea, 
are also absent. 

And here permit me, by the way of an episode, to remark 
that I am disposed to believe that, in bilious dysenteries and 
bilious diarrhoeas, the liver becomes first involved ; the bowels 
subsequently, as a result of the morbicity of that important 
organ. It will not, I hope, be hastily denied, that a complete 
congestion of the portal vessels, and the pouring into the in- 
testinal tube, of a highly acrid secretion of the liver, may give 
origin to all the phenomena which present themselves in bilious 
dysentery or bilious diarrhoea. Certain too, is it, that all the 
remedies which we may address to the bowels for their relief 



NEBINGER ON CHOLERA INFANTUM. 281 

(if we overlook the necessity and importance of relieving the 
liver and correcting its secretion), will at best prove only pal- 
liatives ; whilst, on the other hand, if we heed the necessity 
alluded to, and employ such remedies as address themselves to 
the liver particularly; relieving it of its engorgement, and 
normalizing its secretion, we will have such diseases most 
speedily and kindly yielding to our treatment in many, nay, 
most instances, without recourse to any other class of reme- 
dies. 

To return to the more legitimate subject of our inquiry, I 
have to remark, that the morbid conditions of inflammation, 
ulceration, and softening of the mucous membrane of the in- 
testines ; the enlargement of the glands, solitary and agminate, 
are not peculiar to this disease, but are present to a greater 
or less extent in every fatal case of enteritis, dysentery, &c. 
&c. Yet these diseases do not exhibit the pathological pheno- 
mena of Cholera Infantum. Infancy is the period of life when 
mankind are most prone to attacks of inflammatory and con- 
gestive diseases, which doubtlessly are favoured in their de- 
velopment by the greater degree of irritability existing at this 
period of life, in all the organs and tissues of the economy. 
Thus then we have seen that hepatic derangements, and parti- 
cularly bilious complications of enteric affections, are the dis- 
eases of the tropics, or, in other words, the products of exalted 
atmospheric temperature. We have also seen, that Cholera 
Infantum is a disease coincident with the hotter months of 
summer, in this latitude. If then the heat of the tropics is 
the great predisposing cause of the hepatic derangements of 
adults there, may we not fairly infer that the exalted tem- 
perature of the summer months here, is to the more irritable 
or susceptible liver of infants what the heat of the tropics is to 
that organ in those who are within its influence ? 

Removal from the tropics to the colder latitudes, by those 
afflicted with entero-hepatic derangements, is followed by a re- 
storation of the liver and bowels to their normal condition. 

Removal of the Cholera Infantum patient from the heat 
exalted atmosphere of our cities to the cooler atmosphere of 



282 NEBINGER ON CHOLERA INFANTUM. 

the country, and particularly to that of the ocean's side, is 
followed by a speedy restoration to health. The tropical in- 
valid, when in the cold latitudes, is removed from an atmo- 
sphere of high temperature (the predisposing cause of his entero- 
hepatic affection), and, without the use of remedies culled from 
the diversified fields of the Materia Medica, casts off the habili- 
ments of disease, and in their stead robes himself in the all 
gorgeous costume of health. 

The Cholera Infantum patient, removed from the heat of 
the city to the cool, balmy, and tone-inspiring atmosphere of 
the country, is restored to health without the use of medicine. 
A return of the regenerated tropical invalid to his sunny clime 
is followed by a return of his malady. A return to the city 
during the canicular, of the convalesced Cholera Infantum 
patient, is followed by a return of the disease, ending perhaps, 
in death ! How striking, how wonderful the analogy of these 
two cases under similar circumstances, springing up under like 
conditions, aggravated by similar causes, relieved, nay cured, 
by the same hygienic treatment. Having causes and effects 
so remarkably exact in aspect, and analogous in some of their 
phenomena and habitudes, to what other conclusion can we 
arrive than that there exists an identity between the organs 
primarily affected f But then the pathologist who believes 
that Cholera Infantum is primarily and continuously a disease 
of the alimentary canal, says, Have we not revealed post- 
mortem traces of inflammation, ulceration, and softening in 
the mucous coat of the intestines ? Have we not traces of 
inflammatory action in, and softening of, the mucous tissue of 
the stomach ? To all of which I have to answer in the affirm- 
ative. But I ask in turn, have we not other lesions equally 
manifest ? Have we not another organ and its appendage, of 
as great relative importance in their place and offices in the 
economy as any of those named, exhibiting undeniable evi- 
dence of morbid action ? Have we not always congestion and 
sometimes enlargement of the liver ? Have we not the gall 
cyst containing a very acrid and otherwise vitiated secretion, 
or entirely free from its peculiar fluid ? Has not the total 



NEBINGER ON CHOLEKA INFANTUM. 283 

absence of normal bile been the universal post-mortem reve- 
lation by Cholera Infantum? Have all these lesions and 
conditions no legitimate interpretation ? Do they import 
nothing ; and must they be viewed as merely accidental or in- 
cidental, according as it may suit the taste, fancy, or prejudice 
of the pathological investigator ? For my part, I think when 
taken into consideration with all the circumstances, all the 
phenomena of the disease in the dead and in the living, they 
stand out in bold relief upon the foreground of the picture 
as its most attractive and interesting characters. 

Again, if the presence of lesions in the abstract, without 
taking into consideration the phenomena of the disease which 
present themselves during the lifetime of the patient, will war- 
rant the deduction of a conclusion in regard to its nature ; 
why separate, in the disease under consideration, the morbid 
conditions, independent of the lesions of the stomach and bow- 
els, from them, and consider the disease an enteric, gastric, or 
gastro-enteric malady ? Why not group them, making them 
a unit, and consider the disease a hepatic gastro-enteric malady 
primarily and continuously ? If we refuse to do this, by what 
authority, by what common sense rule, shall we, after discover- 
ing lesions of the stomach, bowels, and liver, close our eyes to 
part of them, and determine the nature of the disease by the 
balance of the morbid anatomical manifestations ? Would it 
not be more wise to group all the lesions together en masse in 
the disease under consideration, and then regard it as a hepatic 
gastro-enteric derangement ? and thus, while we shall not deter- 
mine where the disease commenced, in what tissue or organ it 
raised its hydra head, we shall at least make no conclusions 
to the prejudice of any of the organs involved, and hence our 
conclusion will be less apt to beget an injurious empirical treat- 
ment. I opine, however, that it is an impossibility in most, if 
not in all diseases, to determine their true nature by a consi- 
deration of the morbid conditions presented by organs and 
tissues after death, independent of the morbid phenomena ex- 
hibited during life, and that lesions and living phenomena must 
be studied together, and each given its true weight and value, 



284 NEBINGER ON CHOLERA INFANTUM. 

to enable the pathologist to solve the problem, and arrive at 
an accurate conclusion in regard to its pathology. Therefore, 
to determine the nature of Cholera Infantum, what organ or 
organs, tissue or tissues, become primarily diseased ; whether 
the liver, the gastric, or enteric mucous membrane, or all com- 
bined, we must examine and hold under consideration, not only 
the lesions presented after death, but the phenomena presented 
during life. What, let us inquire, are the chief of the living 
phenomena ? Vomiting and purging. The stools sometimes, 
though seldom, evidence the absence of bile ; but generally the 
presence of a vitiated hepatic secretion can be detected. As 
the disease progresses, we have aqueous or serous matter mak- 
ing up the major part of the evacuations. Mucous discharges 
occasionally take place, more particularly at the dawn of the 
disease than at any other period. In violent cases, we have 
great frequency of stools. Coexisting with the vomiting and 
purging, we have sometimes great prostration and even col- 
lapse, giving to the disease a marked analogy to cholera. 

Having now marshalled some of the phenomena, the living 
phenomena, let us unite them with the lesions presented after 
death, take them as our guides in the exploration we are about 
to make, and observe to what rational conclusion they will lead 
us. We have discovered after death congestion of the liver ; 
the gall-bladder either empty or containing an acrid secretion. 
These are universal conditions. We have, at the very dawn 
of the disease, discharges from the bowels, exhibiting either 
the absence of bile, or the presence of an abnormal hepatic se- 
cretion. So far the phenomena during life and the revelation 
after death are in harmony, and may, as we shall hereafter 
see, be most satisfactorily accounted for, and each phenomenon 
referred to its peculiar cause. Again, independent of the ab- 
sence or presence of abnormal bile we have large and frequent 
discharges of serum from the mucous membrane of the bowels. 
Sometimes mucous or slimy matter is present in the evacua- 
tions. Now, as this serum and slimy matter are the results 
or products of a diseased enteric mucous membrane ; the dis- 
eased conditions of that membrane necessarily preceded the 



NEBINGER ON CHOLERA INFANTUM. 285 

phenomena, of which these are the ultimate products. How 
shall we account for the origin of the diseased condition of the 
mucous membrane just referred to ? Having seen, as a first 
revelation of the living phenomena of the disease, that the 
hepatic function is abnormal, we have thus gained an import- 
ant point from which to make our future observations. We 
shall, therefore, regard the liver as having its portal vessels 
congested, and this the cause of its functional derangement, 
resulting in either non-secretion or the secretion of an abnor- 
mal fluid. Let us now endeavour to see what would be the 
effects of such a condition of the liver, and its vitiated 
secretion or non-secretion, upon the bowels and stomach. The 
portal blood, or that from which the hepatic fluid is secreted, 
is, if I may be permitted to use the term, the effete blood of 
the stomach and bowels. If congestion of the portal vessels 
which ramify through the liver takes place, there must of ne- 
cessity follow a damming up behind them of the blood in the 
channel through which it flows, and a consequent throwing 
bach of the current upon its source. The capillary rete of the 
mucous membrane of the stomach and bowels being the source 
from whence the liver derives its supply of portal blood, there 
necessarily takes place a congestion of a passive character of 
these mucous membranes, giving origin to irritation of the fol- 
licles, and causing effusion and hyper-secretion ; the effusion 
being nothing more than an exosmotic action of the venous 
capillaries of the enteric mucous membrane. Thus we have 
the large serous discharges, and part of the morbicity of the 
mucous tissue of the bowels, accounted for as a secondary result 
of the congestion of the liver. 

Now let us advance a step further, and suppose, as is really 
the case in most instances, that we have, simultaneously with 
this congestion of the mucous membrane of the bowels and the 
exosmotic action of its venous capillaries, a very acrid bile, in 
large quantities and long continued, thrown into the intestinal 
canal ; will we not have sufficient elements, creative of diseased 
action, to produce in the very irritable and delicate mucous 
tissue of a babe's bowels such derangements as follicular en- 



286 NEBINGER ON CHOLERA INFANTUM. 

largement, ulceration, and thickening, to say nothing of traces 
of inflammation ? And if we have, are not such the secondary 
effects of the morbid condition of the liver ? Then we have 
vomiting, true ; and may not this be a result of irritation of 
the gastric mucous membrane, produced by acrid secretions of 
its glands and follicles ; such abnormal acrid secretions arising 
from the congestion of the gastric capillary rete, produced as 
already stated ? Add to this the great probability of morbid 
influences being transmitted from the bowels, and then say if 
the account will or will not embrace all that may be necessary 
to produce the gastric phenomena presented during life, as 
well as the lesions which, after death, are manifest in the mu- 
cous tissue of the stomach. 

Now that we have traced, step by step, the predisposing cause, 
the phenomena, phases, parts involved, and lesions which make 
up this interesting disease, in the regularity of succession in 
which they have naturally or inductively sprung up for exa- 
mination, study, and reflection, I trust we have shown that 
"there is good and sufficient cause" to consider that, in 
Cholera Infantum, the liver is the organ primarily diseased ; 
and that the gastric and enteric phenomena are secondary to, 
hence the offspring of, the hepatic derangement ; thus indi- 
cating the nature or pathology of Cholera Infantum to con- 
sist primarily in a congestion of the liver, followed by, continu- 
ous with, and depending upon it, of a derangement of the mu- 
cous coats of the stomach and bowels ; such gastric and enteric 
derangement manifesting themselves in the form of copious 
secretion, effusion, morbid evacuations, &c. &c. 

The fixing of the original seat and nature of this disease is 
all important as regards the character of the treatment it 
should receive from its incipiency to its final close. It is also 
of vast importance to the little Cholera Infantum patient, 
whether his physician consider the enteric and gastric mucous 
coats, the primary, and may I not add, the only seat of disease, 
and the nature of his malady an enteric and gastric irritation ; 
or that the derangement of those mucous tissues, although very 
active and the most prominent, yet secondary to, and hence de- 



NEBINGER ON CHOLERA INFANTUM. 287 

pendent upon, the morbid condition, the obstructed and vitiated 
function of a passively congested, and perhaps, enlarged liver. 
For the physician in his treatment of the malady will, by ne- 
cessity, be influenced by either view he may adopt. 

Before closing this paper, I cannot refrain from venturing 
the assertion that it fully accords with the observation of every 
medical gentleman who has devoted any attention to this dis- 
ease, let his views in regard to its nature be what they may, 
that Cholera Infantum cannot be considered as presenting a 
truly favourable and yielding aspect, until the stools evidence 
the presence of a healthy hepatic secretion. And if the asser- 
tion I have just made be true, as I verily believe it is, does it 
not, I would ask, point to, and is it not suggestive of the liver 
being the important and controlling seat of disease ? And if 
so, does it not at once indicate the treatment ? Do what 
you like, treat the disease as you may, if you fail to produce a 
flow of normal bile, your patient remains ill, with perhaps his 
malady moderated, but not cured ; the morbid gastric pheno- 
mena may have subsided, the evacuations from the bowels be- 
come less frequent and less copious, and have somewhat altered 
in their physical characters, but unless you normalize the 
hepatic secretion, your patient remains in a doubtful condition. 
Normalize the bile, and, the moment you do so, every bad 
symptom begins to pass away like snow flakes before the sun's 
rays, and a speedy convalescence may be looked for, nay,^?ro- 
mised to the affectionate mother, who has so long anxiously 
bent over, and so untiringly kept her vigils by the couch of 
her suffering babe. 

Philadelphia, June, 1851, 



288 HEX ON ENTERIC FEVER. 



An Essay on Enteric Fever as it prevailed in the County of 
Hunterdon. Head before the District Medical Society for the 
County at the Annual Meeting, May 6, 1851. By Geo. 
P. Rex, M. D. 

At the request of your reporter I cheerfully give you the 
results of my experience in an enteric fever which has pre- 
vailed in this region of country since August, 1849, and is 
unabated at the present time. I exceedingly regret that my 
limited time will not enable me to do that justice to the sub- 
ject its importance demands ; as all I can do is to give you a 
very brief outline. An object in making this report is to 
enable the members of the Medical Society to allay the 
alarm and excitement now existing, relative to the contagious 
character and fatality of this disease. These fears as to its 
contagion and fatality are not founded upon facts, as I con- 
fess in my experience I have not met with a single case that 
established the contagious character of the disease. I have 
seen a member of a large family (ten in number) have this 
disease nine weeks, in its very worst form, who was nursed in 
turn by all the family, and yet this was the only case that 
occurred in that family. I mention this as a single case ; I 
have seen many others like it. 

In regard to the fatality, I am of the opinion that the fears 
in this respect are equally absurd. Although a violent and 
alarming disease, I believe that, if it is properly managed, 
it is not more fatal than the other forms of fever. A reason 
why this form of fever has proved so fatal in some instances is, 
because its true pathology has not been understood. It may 
be stated, almost as a maxim, that enteric fever, improperly 
treated, is the most fatal disease met with in this region of 
country ; and there is no disease that yields more readily to 
the power of therapeutic agents properly applied than it does; 
as the patient generally recovers, however violent the attack, 
if the case is well managed. 

I have had in my own practice, and seen in the practice of 



REX ON ENTERIC EEVERo 289 

others, upward of 100 cases. I regret that I did not keep a 
memorandum of the precise number and its fatality. In my 
own practice I can remember seventy-eight violent cases, six 
of which terminated fatally. I am satisfied there were 
others that I cannot now recollect that were successfully 
treated, but six are all that died. Of these six, one was 
a feeble infant of three months old, which died from ex- 
haustion — one was a phthisical young lady in feeble health, 
who died of perforation of the intestine — one old gentleman 
died from internal hemorrhage — one, a feeble girl, died from 
the effects of a large abscess in the right parotid, formed 
during convalescence — another, a stout athletic man, died from 
congestion of the brain, having had the disease two weeks 
before he would have the physician called — and the sixth 
died from exhaustion. 

The disease was not confined to any season, prevailing 
equally alike in them all ; neither does age or sex exert any 
influence, for I have seen it equally in the male and female, and 
have seen a well marked case in an infant three months old, and 
in an old gentleman in his eighty-fourth year. The majority 
of cases occurred between the ages of fifteen and thirty. 
The disease would usually commence insidiously, and its pro- 
gress was very gradual. I have known patients to complain 
in the initial stage two or three weeks before the disease would 
be established, hence a great difficulty arises in fixing the 
time when it fairly commenced. 

The patient is uneasy, feels wearied and dull, soreness of 
the flesh, some headache, and slight fever, tongue not much 
furred, and the appetite not greatly altered. If the tongue 
is closely examined, a white fur will be found at the root, and 
the patient often has a mild diarrhoea; as the disease ad- 
vances slight chills, succeeded by some febrile excitement, 
often occur ; dullness and a disposition to drowsiness are also 
very frequent symptoms. The pulse in this stage generally 
is but little altered, beating from 75 to 80 ; the skin has a 
dingy appearance, and the intellect is somewhat impaired. 



290 REX ON ENTERIC FEVER. 

This is a general history of the initial stage, although it as 
well as the fully formed stage is exceedingly variable. As 
the disease becomes established, the usual symptoms of fever 
are present, modified by circumstances. Yet there are some 
symptoms that may be regarded as peculiar to this disease. 
I found a hot and dry skin, headache, somewhat accele- 
rated pulse, from 90 to 100 in males, and 120 in females. 
There was not a single exception that I can remember where 
the pulse was less than 120, when the disease occurred in a 
female. Headache, thirst, tongue covered with a thick white 
fur in the early part of the disease, and dry, brown, and 
cracked after the second week. If there was no looseness 
of the bowels, they would always be easily acted upon by 
purgatives, and frequently there was troublesome diarrhoea, 
attended with watery stools. After the second week there 
were dry, brown tongue, tympanitis, and abdominal tender- 
ness, sordes, frequently subsultus, delirium, and profuse he- 
morrhages from the nose or bowels. About this time and 
often earlier, would be seen the lenticular spots about the 
upper part of the abdomen and chest, and I do not recollect 
a case in which they were absent. Later in the disease 
small vesicles cover the abdomen, called sudamina. Diffi- 
culty of hearing, almost amounting to deafness, is a very com- 
mon symptom, and I frequently found a difficulty of voiding 
the urine, and sometimes retention, calling for the use of the 
catheter. Such is a brief outline of the general symptoms 
that are usually present. I have presented them in a desul- 
tory manner, and should have been gratified could I have had 
time to have entered more into details. But the disease is 
well described by Chomel and Louis, of Paris ; and, in the 
work of Dr. Elisha Bartlett, formerly of the University of 
Maryland, may be found a very accurate and minute descrip- 
tion of it, to which you are referred. In all the cases that 
came under my observation, the symptoms indicated a pre- 
dominance of enteric disease; and hence Professor Wood's 
term of Enteric Fever, seems most applicable. 



REX ON ENTERIC FEVER. 291 

The symptoms and progress of the disease are also de- 
scribed in all the modern works on the Practice of Medicine 
that have been published since the investigations of Louis. 
I am well satisfied that its pathology consists of an inflamed 
and ulcerated condition of the glands of Peyer and Brunner, 
and the solitary glands and follicles lining the mucous surface 
of the small intestines. In many of the cases that I saw, 
there was congestion of the liver, and some congestion of the 
brain. In the disease as I saw it, there was more frequently 
hemorrhage from the bowels than is usually spoken of by 
writers, and this constituted one of its chief dangers. 

The discharges were very copious, often amounting to many 
quarts, and were of a dark, melanotic and tarry consistence ; 
and I am of the opinion that they were caused by a rupture 
of some of the vessels of the portal circulation, as several 
patients have told me they could feel something snap in the 
right hypochondriac region, previous to the appearance of the 
hemorrhage. Although I have frequently seen very copious 
discharges, yet I have never seen them prove fatal excepting in 
one instance ; and I believe under the treatment that will 
be described hereafter, very little fatality need occur from this 
cause. 

The pathology of the disease is now generally understood 
by the profession, the only point of difference being the treat- 
ment. As I have stated before, if this disease is not properly 
treated, I believe the majority of the cases will die, and this 
perhaps affords an explanation why such great fatality has 
so frequently existed ; and I am satisfied from my own expe- 
rience, that, if the pathology and treatment are correctly 
understood, few patients will die. As I stated before, the 
cases nearly all vary in their course ; so does the treatment. 
I can, therefore, only give you general principles, leaving you 
to carry them out in the different cases. 

In the commencement or initial stage of this disease the 
treatment is exceedingly variable, much more so than in any 
other stage. If the patient is robust, and the bowels natu- 



292 REX ON ENTERIC FEVER. 

ral, I generally clear out the primae vise with an active 
cathartic of calomel and jalap. If, on the contrary, the 
patient is a delicate female, I always begin with a mild treat- 
ment. The pathological condition that now exists, is an 
irritated condition of the glands of Peyer and Brunner and 
the mucous coat of the small intestines, and in this stage a 
laxative of ol. ricini and laudanum, with rest and proper diet, 
has been my usual plan of treatment. If there was diarrhoea, 
I used the blue pill and opii to lock up the bowels, and then 
clear them out with ol. ricini and laudanum. When the skin 
became hot and dry, I used the eff. mixture, with or without 
the sp. seth. nit. according to circumstances, sponging the 
arms, face and neck with cool lotions, and employing cooling 
drinks. 

When there was headache and delirium, I used sinapisms 
and blisters to the extremities, and ice or cold water to the 
head. 

After pursuing this treatment two or three days, if the 
patient did not improve, I always then used small doses of 
calomel and opium every two hours, until a gentle ptyalism 
was produced, and whenever this occurred the patient has 
always convalesced. I found it impossible in many cases to 
procure any mercurial impression, even after the use of small 
mercurial doses continued for several weeks. When ptyalism 
was produced, the symptoms would abate, the tongue clean, 
and the patient soon recovered. If there was diarrhoea after 
the mercurial impression had become established, or an irri- 
table condition of the bowels, there is no remedy equal to the 
nitrate of silver, given in one grain doses, with or without 
opium, every two or three hours, until the metallic gloss ap- 
pears in the stools. 

When my efforts were not successful thus far, and the 
tongue became dry and brown, with red edges, tympanitis and 
tenderness of abdomen, with proper management, I have al- 
ways succeeded, except in one case, with the ol. terebinth, 
and iod. potass. 

I generally covered the abdomen with a mush poultice 



REX ON ENTERIC FEVER. 293 

sprinkled with mustard, or applied a blister, and then used the 
01. Terebinth, gtt. x., lod. Pot. gr. ss. to gr. j, in an emulsion 
of gum arabic every two hours. I am satisfied the 01. Tere- 
binth, has often been misused to the injury of the patient. I 
have seen it used too early in the disease with marked injury, 
and this has been done, in my opinion, from not understand- 
ing the pathological condition. We have in this disease 
first, irritation, then inflammation, and lastly, ulceration. It 
is only in the last stage that the 01. Terebinth, is useful, and 
here it acts like a charm, it produces an alterative effect 
upon the ulcerated surface, and promotes granulation and 
cicatrization. But if this remedy is used when a state of 
inflammation exists, it acts as a stimulant, and often does irre- 
parable mischief. Great discrimination is required in the use 
of this remedy, and when properly used there is no one in the 
Materia Medica that possesses more value. As to the hemor- 
rhagic discharges from the bowels, I have always been able to 
restrain them with astringents, as the tinct. catechu, tannic 
acid, kino, acet. plumb., according to the state of the system. 

Case I. — A. D., setat. 11, a healthy girl, had complained of 
not feeling well for several days, previous to Wednesday, Jan. 
15, 1851, when she was chilly, had pain in the back, followed 
hj slight fever, and during the night was awakened several 
times, caused by frightful dreams. I saw her first on the 16th ; 
she then had slightly furred tongue, pulse 90, skin warm, dull 
expression of the countenance, some pain in the head, bowels 
rather costive. Prescribed four powders containing Hyd. 
Chlor. Mit. gr. j, P. Ipecac, gr. J, one every four hours ; gtts. 
xxx of Sp. iEth. Nit. ; two hours after each powder, sponging 
the neck, arms, and head with cool lotion, with the use of cold 
drinks. 

1*1 th. — Has passed a more comfortable night ; increase of 

fever, pulse 98, tongue coated with a white fur, and rather 

brown in centre; skin hot and dry; increase of pain in the 

head; bowels not moved; complete anorexia. Prescribed 01. 

vol. iv. — 24 



294 REX ON ENTERIC FEVER. 

Bicini f3ij ; and after the operation three powders same as yes- 
terday, with warmth to the feet, and cooling applications to 
the head. 

18th. — Bowels moved twice yesterday ; pulse 110, tongue 
more heavily coated, intense pain in the head ; hands and feet 
cool, the rest of the body hot and dry ; complains to-day of 
some tenderness in the right iliac region, when hard pressure 
is made. Prescribed four powders, Hyd. Chlor. Mit., and 
Ipecac, as before with the effervescing mixture, warm pedilu- 
vium, sinapisms to feet, and ice water to the head. 

19th. — Bowels opened once since yesterday, dark discharge; 
pulse 106, tongue more coated ; feverish odor very strong ; 
skin more cool and less pain in the head. At 2 o'clock this 
morning, patient had a chill, which lasted half an hour, suc- 
ceeded by active fever three hours. Prescribed five pow- 
ders the same as before, and effervescing mixture. 

20th. — Has had two paroxysms of chill succeeded by fever; 
skin hot, pain in the head abating, tongue less coated, pulse 
116. Prescribed effervescing mixture with Sp. 2Eth. Nit. 
gtts. xxx every four hours, and when the fever abates gr. ij 
Sulph. Quin. every two hours until gr. x were taken. 

21st. — Passed a comfortable night ; no chill, skin cool, head 
free from pain, pulse 106 ; bowels moved once very freely, dark 
bilious discharge ; tongue disposed to clean. I observed to- 
day slight ptyalism. Prescribed effervescing mixture every 
4 hours. 

22d. — Pulse 120 ; more ptyalism ; skin hot, tongue clean- 
ing, bowels irritable, having been opened four times since my 
last visit. Saw this morning about thirty lenticular spots on 
the abdomen. Prescribed Pulv. Ipecac, et Opii gr. ij every 
3 hours. 

23d. — Pulse 112 ; tongue not altered ; ptyalism not in- 
creased ; had some fever during the night ; did not rest well ; 
has had three evacuations ; increase of the lenticular spots. 
Prescribed Dover's powders, gr. ij, every three hours as be- 
fore, and effervescing mixture if fever returns. 

24th. — Pulse 100; tongue cleaning, ptyalism increasing; 



REX ON ENTERIC FEVER. 295 

bowels opened once ; increase of the spots upon the chest and 
abdomen; skin cool and moist; countenance improved ; desires 
some food to-day, for the first time ; under a mild treatment 
the patient convalesced, and was discharged Feb. 1. 

Case. II. — T. D., a mute, aetat. 25, complained of slight 
chilliness and pain in the bowels, and appeared dull for a week 
prior to 18th of Dec. last, when I first saw him. I found 
him with a hot and , dry skin, headache and loss of appetite, 
pulse 75, tongue moist and clean except at, or near the root, 
where it was covered with a white fur ; had considerable cough 
and pain in right breast. I gave calomel and jalap aa gr. 
xij with warm pediluvium and sinapisms to feet, and cold ap- 
plications to the head ; on the succeeding day he was greatly 
improved, so much so that I did not think it necessary to 
give him any medicine. 

On the 20th he was worse, complaining of violent pain in 
the breast, and a cough ; bowels not moved since yesterday ; 
pulse 80. I prescribed a blister to chest, and solution of 
Antim. et Potass. Tart.; under this treatment he improved 
very rapidly, and bade fair soon to be well. 

On the 22d he was again worse, complaining of headache 
and soreness in the flesh, tongue coated with a thin white fur, 
pulse 84, skin hot and not very dry; bowels not moved since 
yesterday. Prescribed four powders of Calomel and Ipecac, 
one every 3 hours. 

On the 23d, he was still worse ; tongue now presented a 
brown, dry, and cracked appearance; pulse 84, pain in the right 
iliac region, skin hot and dry. Prescribed R Mass. Pil. Hyd. 
gr. xij ; Ipecac, gr. ij ; Opii gr. ij in pil. xij, one every two hours, 
and every intervening hour the effervescing mixture with 30 
drops Sp. iEth. Nit. ; epispastic to right iliac region. This 
treatment was continued from the 24th to the 27th, the tongue 
occasionally showing a disposition to become moist, but most 
of the time was dry and brown, with sordes about the teeth, 
and dirty appearance of the skin. Under the use of the blue 
mass his bowels moved once in every 24 hours. 



296 REX ON ENTERIC FEVER. 

On the 28th his tongue was perfectly dry and brown, sordes 
full on the teeth, abdomen tympanitic and covered with lenti- 
cular spots, pulse remaining 84. I then prescribed 01. Tere- 
binth, gtt. x. and Iod. Potass, gr. j. in Emuls. G. Acacise 
every two hours, and covered abdomen with a mush poultice 
sprinkled with mustard ; cool drinks to be employed. 

This treatment was continued until Jan. 5, when the bowels 
becoming too loose, were checked with pills of Nit. Silver, and 
Opium, J gr. of each every three hours ; he took ten of the 
pills, and then they were omitted, and the 01. Terebinth, mix- 
ture resumed. 

On the morning of the 7th the chest and abdomen were 
covered with a large crop, of sudamina, which were easily ob- 
served by looking between the patient and the light; bowels 
moved once in the last 24 hours ; abdomen tympanitic and 
gurgling upon pressure. About 12 o'clock he had profuse 
melanotic hemorrhagic discharges from the bowels. Prescribed 
Acet. Plumb, gr. v, and Opii gr. J, every two hours, with 
milk punch. In the evening I saw him again ; had one dis- 
charge since 2 o'clock; pulse small and 106. Prescribed 
Acet. Plumb, and Opii, and the milk punch freely. 

Jan. 8th. Has had no discharge from his bowels since my 

last visit; tongue still dry and brown, and abdomen tympanitic 

and tender. Prescribed the Mist. 01. Terebinth, and blister to 

abdomen. 

9th. — Bowels quiet, tongue more moist ; prescribe same. 

10^/i. — No operation on the bowels ; tongue the same as yes- 
terday ; prescribe an enema of cold water and continue the 
mixture. 

llth. — Enema operated twice, bringing away dark dis- 
charges, having the smell of decomposed blood ; tympanitis di- 
minished and tongue more moist. The 01. Terebinth, mixture 
was continued until the 15th, when the tongue had become 
moist and clean, and pulse and skin natural. All medicines 
were omitted, and the patient convalesced slowly, having been 
under treatment 29 days. 



DOANE ON ACIDS. 



297 



Table showing the Acids which contain similar numbers of 

Oxygen atoms. 

Mr. Editor : 

The fact that I have never met with a table similar to the 
one for which I ask an insertion in your Journal, is no proof 
that such an one does not exist. The words "plagiarism" 
and "plagiarist," have become so ridiculously frequent of late 
that hardly a positive statement of originality is allowed to 
stand in the way of their use. Even such small matters as 
this do not escape. Experience has shown the usefulness of 
this as an aid in both teaching and learning the system of 
chemical notation as exemplified in the more common acids. 

GEORGE H. DOANE, 
Instructor in Chemistry in Burlington College. 



1 eq. of oxygen 



2 eqs. of oxygen 



3 eqs. of oxygen 



4 eqs. of oxygen 



5 eqs. of oxygen 



Acids Containing, 

Cyanic, 

( Acetylous 
J Carbonic, 
j Selenious, 
[ Sulphurous 

f Acetylic 

Arsenious, 

Boracic, 

Chromic, 

Silicic, 

Manganic, 

Sulphuric, 

Phosphorous 
[ Selenic, 

J Antimonious 
j Nitrous, 

' Antimonic, 

Arsenic, 

Iodic, 

-j Chloric, 

I Nitric, 

j Phosphoric 

[Bromic, 



CyO 

Ac0 2 
C0 2 

Se0 2 
S0 2 

AcO s 
As0 3 
B0 3 
Cr0 3 

Si0 3 
MnO- 
S0 5 
P0 3 

Se0 3 

Sb0 4 
N0 4 

Sb0 5 
As0 5 

io 5 

cio 5 

N0 5 

po 3 

BrCL 



298 LETTER FROM DR. YARDLEY. 



Extract from the Minutes of the Annual Meeting of the Dis- 
trict Medical Society, for the County of Monmouth, held at 
Freehold, April 28th, 1851. 

The President, Dr. J. Vought, in the chair. 

Present fourteen members. 

The minutes of the last meeting were read, adopted, and 
directed to be recorded. 

Dr. R. W. Cooke reported a case of encysted dropsy suc- 
cessfully treated after tapping by manipulation, for which a 
vote of thanks was given, and a copy requested for/publication. 

The Society then went into an election of officers for the 
ensuing year, which resulted as follows : — 

Drs. R. Laird, President ; D. TV. Barclay, Vice-President ; 
D. Polhemus, Secretary; and E. Taylor, Treasurer. 

The Delegates to represent the Society in the State Medical 
Society, for one year, were selected as follows : — 

Drs. R. Laird, TV. A. Newell, D. Polhemus, and E. Taylor. 

After the report of the Finance Committee, the society ad- 
journed to meet at their usual time and place. 

D. POLHEMUS, Secretary, 



American Medical Association. — Letter from Dr. Yardley. 

The following letter from Dr. Yardley corrects an error 
which appears in the report of the transactions of the Ameri- 
can Medical Association, on page 267 of our last number. 
We are very glad of the opportunity of correcting the error, 
which we perceive has crept into several other journals. The 
resolution and accompanying observations of Dr. Yardley, 
commend themselves to the attention of the profession gene- 
rally, and we hope the subject will be brought before our 
district and state societies. — [Editor N. J. Med. Reporter.] 



LETTER FROM DR. YARDLEY. 299 

Philadelphia, June 13, 1851. 

Dear Doctor — I will be obliged, if you will correct an 
error of your last number, in relation to the resolution offered 
hj me at the late meeting of the " American Medical Associa- 
tion" in Charleston. 

The following are the preamble and resolution as adopted 
hj the Philadelphia County Medical Society : — 

" Whereas, The Constitution of the American Medical 
Association, by providing for the reception of delegates from 
all "permanently organized medical societies, medical colleges, 
hospitals, lunatic asylums, and other permanently organized 
medical institutions," unjustly favors the profession in cities 
where such institutions exist, and can be readily formed, 
and diminishes the importance, and thereby discourages the 
formation of county medical societies in rural districts ; 
therefore 

" Kesolved, That the Constitution of said Association should 
be altered so as to admit only delegates from county or state 
medical societies." 

While on the subject, I will, with your permission, correct 
an error which exists in regard to the objects of those who 
offered this resolution ; we do not desire, as has been asserted, 
to exclude professors from the association. We wish, in the 
language of Dr. Drake, to popularize the association with the 
mass of the profession, and transact the business on purely 
republican principles. 

As the Constitution stands, the ratio of representation is 
more than three times as great from medical schools, hos- 
pitals, &c, as it is from the mass of the profession, or county 
medical societies, and is necessarily productive of jealousy ; 
and we hear the distinction, professors and laymen, as at 
Cincinnati; and this jealousy exists even between the rival 
schools themselves, for at Charleston, we had the delegates 
from one medical school protesting against the reception of 
delegates from another. 

Physicians are the Best judges of the moral worth and 
professional respectability of their immediate neighbors ; but, 



300 LETTER FROM DR. YARDLEY. 

by the present Constitution, the members of a county society 
may unanimously exclude a number of physicians from 
membership with them, and the rejected applicants may 
immediately organize themselves into a medical association, 
or obtain a charter for a medical school, and send delegates 
to the association. 

If the proposed alteration in the Constitution is effected, 
professors who love their profession, and feel an interest in 
their association, will join county medical societies, and in 
return, the societies will be proud to elect them as delegates, 
for they generally are, and always should be, the most intel- 
ligent and respectable of the profession. 

Let the physicians of each county in the United States, 
form themselves into a society, and have their Constitution 
approved by the censors of the State society, and let the 
Constitutions of all State societies be approved by censors 
appointed by the American Medical Association. Let every 
member of a county society, be a member of his State 
society, and of the American Medical Association, and re- 
ceive a certificate to that effect, and contribute to their funds ; 
then will we have realized the exalted idea of Professor 
Meigs. We will have from twenty to forty thousand members, 
without any privileged classes among us, but each one entitled 
to a vote in the choice of delegates, and each one contributing 
his quota to the funds of the association, giving us an income 
of from twenty to two hundred thousand dollars, sufficient to 
reward labor and encourage enterprise, and thus giving us 
invaluable influence and power. 

A certificate of membership from the great " American 
Medical Association,'' will then be of more value to a young 
man than all the diplomas of all the medical schools in the 
country, for the inquiry will not be, is he a graduate, but, is 
he a member of the American Medical Association ; do the 
respectable physicians who are his immediate neighbors, and 
who are best qualified to judge, regard him as an intelligent, 
educated, honorable man, with whom they are willing to have 
professional and social intercourse ; or, do they regard him 



BIBLIOGRAPHICAL NOTICE. 301 

as an ignorant, uneducated man, who resorts to any means 
however dishonorable, for the purpose of obtaining practice 
and popularity. 

There are other arguments in support of the resolution, 
but it has been referred to a committee, the intelligent chair- 
man of which, I have no doubt, will place the subject in its 
proper light. I have only attempted to correct an error, 
and to " define our position," and as it is an important altera- 
tion in the Constitution, to be acted on at our next meeting, 
I think it is proper that the profession should discuss the 
matter, and that medical societies particularly should express 
their opinion. Very respectfully, &c, 

THOS. H. YARDLEY. 

To Joseph Parmsh, M. D. 



BIBLIOGRAPHICAL NOTICE 



The Physician' 's Prescription Booh, containing list of terms, 
phrases, contractions and abbreviations used in prescriptions, 
with explanatory notes ; also the grammatical construction of 
prescriptions, etc. : to which is added a key, containing the 
prescriptions in an unabbreviated form, with a literal transla- 
tion ; intended for the use of Medical and Pharmaceutical Stu- 
dents. First American, from the tenth London edition. 
Philadelphia, Lindsay & Blakiston, 1851, pp. 288. 

We consider that the enterprising publishers of the above 
work have been peculiarly happy in their selection of a foreign 
work, to reproduce in this country. The title-page, which we 
have copied entire, will sufficiently indicate the object of the 
work, and it only remains for us to say, that we consider that 
the author has well executed his task. We are heartily glad 
of one thing, that is, the work is presented on its own intrinsic 
merits, without the flourish of an American "editor" and 



302 EDITORIAL. 

"reviser," which too often proves to be a farce, excepting so 
far as it serves as an advertisement for the soi disant editor. 

We are sorry that the publishers have not used the distinct- 
ive mark for fluid measures, as has, we think, been very pro- 
perly adopted in the Pharmacopoeia of the United States. 

If other pharmacopoeias would follow the example of our 
own, and give their directions for the compounding of medi- 
cines in English, and if physicians would all write their direc- 
tions in English, much of this little work would be superfluous ; 
but as long as such is not the case, " The Physician's Prescrip- 
tion Book" will be found a very useful work, and is well worthy 
a place in the library of every one engaged in the practice or 
dispensing of medicine. * 



EDITORIAL. 



A WORD WITH SUBSCRIBERS. 

Quite a number of our subscribers are in arrears for the 
current volume of the Reporter, which now draws near its 
close. 

This embarrasses the publisher very much, as his bills must 
be paid whether subscribers pay theirs or not. We do not 
suppose that any of our friends intentionally neglect this 
duty, but are disposed to attribute it to want of thought on 
their part. They forget that the publisher depends on two 
dollars here, and two there, and that these small amounts form 
the aggregate of the hundreds of dollars, which he has to pay 
to his printers. The extra outlay which has been incurred in 
improving the work, calls not only for promptness in paying 
the subscription, but for efforts on the part of the friends of 
the work to increase its circulation. 



EDITORIAL. 303 

DISTRICT SOCIETY MEETINGS. 

Dr. Polhemus will please accept our thanks for the minutes 
of the Monmouth County meeting. Will Br. Cooke favor us 
with the report read on that occasion ? 

We wish the Secretaries of all the District Societies 
would furnish us with the minutes of their meetings, and what- 
ever of interest transpires on those occasions. This would not 
only add greatly to the interest of the' meetings, but facts 
would often be reported which would be of importance to the 
profession generally. * 



We would call the attention of the District Reporters and 
the profession generally, to the following circular of the chair- 
man of the Standing Committee of the N. J. Medical Society. 
This committee has hitherto been much embarrassed in its 
operations on account of reporters and others not giving as 
much attention to the making out of reports as the subject 
deserves. — [Editor]. 

To the District Medical Societies in the State of New Jersey. 

The Standing Committee, appointed at the last meeting of the State 
Medical Society, anxious to make their report as full and interesting as 
they possibly can, respectfully invite from members of the profession 
generally, contributions and reports on those points particularly alluded 
to in the by-laws of the Society : viz. 

1st. The nature and mode of treatment of any epidemic which may 
have occurred. 

2d. Curious medical facts, discoveries, or remarkable cases. 

3d. Observations on medical or philosophical subjects, either of a 
general or local nature. 

4th. Any irregularity, neglect, or contempt of the laws, rules, and 
regulations of the State Medical Societies. 

The committee would respectfully call attention, not only to the 
change of the time of meeting of the Society, but to the alteration in the 
laws, repealing the appointment of "District Reporters" and providing 
for " a reporter from each District Society, requiring him to report to 
the Standing Committee, on or before the 1st of January, annually." 
The committee would, however, solicit those who may favor them with 
communications, to forward the same on or before the 15th of December, 
to Dr. J. B. Munn, Chatham, Morris Co., Dr. A. Coles, Newark, Essex 
Co., or to 

JAS. PAUL, Chairman. 

Trenton, N. J., June 10th, 1851. 



ECLECTIC AND SUMMARY DEPARTMENT. 



Sprains.- — Unquestionably, these apparently trifling acci- 
dents sometimes assume features of the gravest importance ; 
yet with a library at hand containing most of the standard 
works on surgery, we can find but little that is satisfactory 
with regard to either the pathology or treatment of sprains. 

The number of the American Journal of the Medical 
Sciences, for January, contains the summary of an article by 
M. Baudens, in which that distinguished surgeon recommends 
the continued application of cold to a sprained joint, which he 
does by immersion of the affected part in a vessel of cold water, 
iced if necessary, and retaining it in that position for hours, 
and sometimes even for days. When the inflammation has 
been subdued, he applies a gummed bandage firmly and evenly 
around the joint. The latter strikes us as a very important 
feature in the treatment, though, we confess, we were not very 
favorably struck with the application of cold in the manner 
recommended, especially as our predilections were for a course 
of treatment in the early stage, apparently diametrically oppo- 
site. We were very glad, therefore, to find in the April num- 
ber of the same Journal, an article from the pen of Samuel 
Jackson, M. D., late of Northumberland, which, we think, is 
worthy of attentive perusal, and which recommends a course 
of treatment more in accordance with our own experience and 
observations. 

One objection to Baudens' treatment is, as Dr. Jackson sug- 
gests, the dependent position of the limb. 

Baudens opposes the employment of local bloodletting in 
any stage of the treatment of sprains, though, we think that, 
under the restrictions named by Dr. Jackson, it may be very 
advantageously resorted to. Dr. J. would not hesitate to apply 
leeches freely after reducing the general arterial action if ne- 



ECLECTIC AND SUMMARY DEPARTMENT. 305 

eessary, followed up by great elevation of the limb, and the 
application of cold by means of bladders filled with snow or 
ice, or of cloths wet with cold water ; this always preceded, 
however, by the course of treatment to be mentioned soon. 

Warm poultices are unqualifiedly condemned by both the 
above named gentlemen. 

Dr. Jackson recommends that a sprained joint be immedi- 
ately immersed in warm water, as hot as can be borne. It has 
for many years been the custom of the father of the writer to 
use warm applications in sprains, a favorite one being common 
cotton batting fried in butter until it becomes brown, and ap- 
plied as hot as can be borne. This, we think, will in most 
instances, be found to be a very useful application. The writer 
remembers when in his tutelage, calling one day at a house in 
a part of the country where medical men were few, and it was 
necessary to send many miles when one was needed. Observ- 
ing that a lady who rose to meet him, limped very much, he 
learned that, some hours previously, she had sprained her 
ankle. She was recommended to apply the cotton batting as 
above. The remedy had the desired effect, as his friend was 
speedily relieved. Dr. Jackson has no recollection of using 
the hot water after a lapse of two hours from the receipt of 
the injury, but in the case just mentioned, it must have been 
at least six or eight hours after the accident before the remedy 
was applied. 

Dr. Jackson's remarks on blisters are so well timed, and so 

generally applicable, that we copy them entire. * 

" After an indefinite time when all tendency to active spreading inflam- 
mation has been subdued and the little that is left is very feeble or con- 
fined to a small space, a very active large blister will generally absorb 
and carry it forthwith out of the body, but this is a perilous experiment 
and may do much harm if it do not fulfil our intention of extinguishing 
at once the whole disease, or of subduing it so far as to prevent reaction 
and thus to favor the operation of a second blistering. Whenever it 
has been determined to use this remedy, the part ought to be rubbed for 
fifteen minutes with decoct, canthar. ex terebinth, and an active plaster 
applied, so as to draw an effectual blister in the shortest time possible. 
The quick drawing of the blister is a point of the first importance in cases 
wherein you hope to absorb and carry off the whole disease. A slow 
blister is worse than none; it is sure to irritate and increase the disease, 
as sinapisms are known to do in similar cases. You are taken with 



306 ECLECTIC AND SUMMARY DEPARTMENT. 

pleurisy or peritonitis — some physicians would apply mustard with the 
hope of discussing a disease that is yet mild ; but vce vobis, you must 
lose more blood on account of the mustard, and resort to a blister in the 
end. The best dressing by far for the first few days, is plantain or cab- 
bage leaves ; but if the blister promise to run freely and not inflame, it 
may be soon dressed with mezereon or savin cerate, and if a copious dis- 
charge of pus be obtained, the disease will rapidly pass away. I can 
never forget the delighted countenance and applauding language of an 
old physician to whom I showed in my first year's practice, an ankle in 
this very condition. He had never known this use of savin, but from 
that day he used it freely and praised it highly. I had learned it from 
Crowther's work on white swellings. 

" Beware of warm poultices in the dressing of these blisters, for, as 
M. Baudens rightly says, "they favor in place of opposing the afflux of 
fluids to the part," and speaking of the long application of warm cata- 
plasms, he says, "the long maceration the joint has been submitted to, 
deprives it of its elasticity, gives rise to a pasty engorgement and pre- 
disposes to the formation of white swelling." If it is determined not to 
use savin, the blister should be healed by the mildest dressings, so that 
another maybe soon drawn; thus the blistering maybe conducted with- 
out any injurious irritation and made to absorb gradually and to carry 
off gently all the remaining inflammation. Dr. Rush used to talk and 
lecture much on his blistering point, and truly no idea or language can 
be more appropriate. The inflammation must be brought down to a low 
grade of action, or to a small periphery, so that a suitable blister will 
extinguish it at once, or so greatly diminish it that one or more subse- 
quent blisters may be drawn with safety and success. 

" Of so much importance is it to guard against the irritation of blisters, 
that when I have applied them in the evening for critical diseases ad- 
mitting of no delay, I have risen from my bed to bleed the patient if 
necessary at the time the plaster might begin to stimulate. When prac- 
ticing in Northumberland, I have thus gone from one mile to four be- 
tween midnight and morning to subdue the possible increase of fever 
either by the lancet or by additional doses of tartar emetic. By this 
means the evils of blistering may often be prevented ; but as Hippocrates 
says, ' the opportunity is fleeting :' if you wait till morning the pulse 
may be higher than it was in the evening, and of course the blister has 
done much harm and no good. 

"It is very possible that when bleeding is inadmissible, nauseating 
doses of tart. emet. might be used to relax the system under the stimu- 
lation of a blister. 

"We have already entered our caveat against warm poultices in the 
dressing of blisters for sprains, and have approved M. Baudens' doctrine 
with respect to them ; and lest any one should retort that our hot water 
may have the same bad effect, we must remind him, that Ave explode 
warmth after inflammation is formed. You may bathe a healthy limb 
in hot water for twenty-four hours and no engorgement will follow. I 
have bathed a great many sprained joints in the hottest water that could 
be borne without any of this evil. It is pain and inflammation that in- 
duce this engorgement, and these being both prevented by the hot bath- 
ing, this dreaded evil is prevented of course. But let this engorgement 
accrue and it will be greatly increased by much heat in any form. Yet 
there may be old cases in which hot water or steam may appear to re- 
vivify the torpid parts and render them sensible to curative means. 



ECLECTIC AND SUMMARY DEPARTMENT. 307 

But suppose you are called to an old case of this leuco-phlegmatic tor- 
pidity, is there a better remedy than frequent blistering that discharges 
freely ? B. Bell recommends the pouring of warm Bath or Buxton water 
on these engorged and torpid joints, but there is far more vivacity in 
the operation of cantharides, and the discharge not only carries off the 
evil stimulation, but it empties the vessels and promotes absorption." 

The Teeth. — Dr. A. C. Castle, of New York, divides the 
teeth into four different classes or groups, according to their 
physical appearance, in connection with, and significant of 
the peculiar diathesis and pathological predisposition of the 
individual. 

I. The large dense yellow teeth. 

II. The dense yellowish white teeth. 

III. The chalk-white teeth, the yellow transparent teeth, 
and the yellow chalky teeth. 

IV. The transparent white teeth, and the bluish white or 
pearly teeth. 

The possessors of the firm large dense yellow teeth, are 
blessed with a sound constitution and vigorous health, a firmly 
knitted frame, and great muscular strength, with the outlines 
of manly dignity and beauty. Those of the second class, 
whilst they possess these gifts in a less marked degree, their 
features presenting a softer expression, and their lineaments 
a full and rounded form, do not the less enjoy the general 
good health allotted to man. The third class, the chalk-white 
teeth, the yellow transparent teeth, and the yellow chalky 
teeth, denote a strumous diathesis ; and the fourth class, the 
transparent white teeth, and the bluish white or pearly teeth, 
so much envied, and so much prized and poetized, bespeak 
for the unhappy possessor a tendency to scrofulous tuber- 
cular phthisis — a mark I consider as sure as is Eddystone 
lighthouse a warning of the rock beneath. — Boston Medical 
and Surgical Journal, April 30, 1851. 

A New Remedy for the Scurvy. — The Surgeon- General 
of the Army publishes the substance of an official report by 
Assistant-Surgeon Glover Perm, United States Army, stating 
that the Maguey or Agave Americana is a very efficacious 
remedy in scurvy. Mr. Perin has used it in Texas, and in 
every case with marked improvement over those cases in 
which lime juice and other anti-scorbutics were used. 

" The juice of the Maguey contains a large amount of 
vegetable and saccharine matter, and of itself is sufficiently 
nutritious to sustain a patient for days. 



808 ECLECTIC AND SUMMARY DEPARTMENT. 

" This succulent plant grows indigenous in most parts of 
Texas, and, if I am correctly informed, in New Mexico and 
California. In Mexico it is well known as the plant from 
which they manufacture the • Pulque,' and grows in great 
abundance. As it delights in a dry sandy soil, it can be 
cultivated where nothing but cacti will grow ; for this reason 
it will be found invaluable to the army at many of the western 
posts where vegetables cannot be procured. 

" The manner in which it is used is as follows : The leaves 
are cut off close to the root ; they are placed in hot ashes 
until thoroughly cooked, when they are removed and the 
juice expressed from them. The expressed juice is then 
strained, and may be used thus, or may be sweetened. The 
dose is from two to eight ounces, three times daily. It is not 
disagreeable to take, and in every instance it has proved to 
agree well with the stomach and bowels. After the leaves 
have been cooked, the cortical portion near the root may be 
removed, and the white internal portion eaten. It appears to 
be a wholesome and nutritious food, and I have been informed 
upon good authority, that several tribes of Indians in New 
Mexico make use of it in the same manner. The use of the 
leaf in this way, I believe, will ward off most effectually in- 
cipient scurvy." — Philadelphia Ledger. 

Malformation of the Bladder and G-enital Organs. — Dr. 
James Ayer publishes in the Boston Medical and Surgical 
Journal, a case of malformation of the bladder and genital 
organs, occurring in a male infant. The malformation is very 
similar to that in the case of Joseph Hayden, an unfortunate 
young man who recently passed through this State, and was 
probably seen by many of our readers. It consists in the 
entire absence of the anterior portion of the bladder and 
wall of the abdomen, and the consequent extroversion of the 
posterior portion of the internal surface of the bladder, 
exposing the mucous membrane, with the orifices of the 
ureters to full view. Several of these unfortunate cases 
have been reported, and they occur more frequently in males 
than in females. * 



THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. IV. EIGHTH MONTH (AUGUST), 1851. No. 7. 

Remarks on the Use of Indigenous Plants. — Podophyllum 
and Bracontium. By E. A. Heintzelman, M.D. 

I here present to the profession a few remarks on a very 
important subject, viz : the investigation of our indigenous 
plants. My object is merely to lay before the intelligent 
reader the result of my experience in the use of some of them, 
and to state the conclusions I have drawn therefrom. If 
these conclusions should not coincide with the opinions of 
others, the labor spent in my investigations has afforded use- 
ful instruction to myself: and if the perusal of them will 
prompt others to study this important subject, the object which 
I have in view will be completely obtained. The numerous 
indigenous plants of our country, which are applicable to 
medical use, and capable of cultivation among us, behoves 
every American practitioner to ^tudy their qualities, with a 
view of ascertaining their remedial powers. If we turn to the 
pages of the Materia Medica, we will find many of our indi- 
genous plants wholly neglected, whilst foreign articles of sim- 
ilar virtues are highly lauded in the treatment of disease. 
From numerous experiments, I am inclined to believe there 
are many plants growing in our soil applicable to the diseases 
with which we are visited ; but which, for want of proper in- 
vestigation, have been allowed to pass by unnoticed, or set 
down in books as useless. This negligence, on the part of 
the country practitioner, is attributable, no doubt, to the 
facility with which the foreign articles can be procured. 
Among the indigenous plants to which my attention has been 
vol. iv. — 25 



310 HE1NTZELMAN ON THE USE OF INDIGENOUS PLANTS. 

devoted, there seems to be none more worthy of notice than 
the Podophyllum, or May-apple, and Dracontium, or Skunk 
Cabbage. I have used the root of the May-apple in my prac- 
tice for the two past years, in numerous cases requiring a 
brisk cathartic, and in hepatic congestion, with very happy 
effect ; and have also used it as a hydragogue cathartic, and 
consider it as efficacious as Jalap and other foreign articles 
which are classed under that head. I see it mentioned in the 
U. S. Dispensatory, that in small and divided doses, it is 
supposed to reduce the frequency of the pulse — an effect 
which I have never been able to obtain, although I have re- 
peatedly administered it in small and repeated doses, with a 
view of testing its power in this particular, and have always 
been disappointed ; but, from some experiments with the 
leaves (which are supposed to be poisonous) I have good rea- 
son to believe them to contain sedative properties, and to act 
as poison in the same way as Belladonna, Stramonium or other 
narcotic plants. 

The second article which I have made the subject of my in- 
vestigations is the Dracontium Foetidum. This grows abund- 
antly in swamps, and other low, wet places. Throughout our 
State, its flowers appear about April, and in lower latitudes, 
much earlier ; all parts of it have a disagreeable odour, which 
resembles that of Mephitis Americana, or common Skunk, 
from which circumstance it has received its name. The root 
is the part which I have used in my practice, and it should be 
gathered in autumn, or early in spring, and dried with great 
care. The root as found in our shops, is generally of an in- 
ferior quality, owing to long keeping, from the slight demand 
for the article. 

I used this plant in an epidemic pertussis, which prevailed 
in my neighborhood during the winter of 1850, with unequivo- 
cal benefit : in cases of a purely spasmodic character, and 
after depletion, in cases attended with inflammatory symptoms, 
and where it failed of entirely eradicating the disease, it al- 
most always mitigated the severity of the symptoms. I have 



HEINTZELMAN ON THE USE OF INDIGENOUS PLANTS. 811 

also used it in phthisis pulmonalis, and consider it a remedy of 
undoubted efficacy. I have used it in the diseases above 
mentioned in the form of syrup ; but as its virtues are supposed 
to be impaired by the application of heat, I have prepared an 
infusion by displacement, in the proportion of one oz. of the 
root, to a pint of water, adding sugar sufficient to bring it to 
the proper consistency; and giving it in doses of from a half 
teaspoonful to a tablespoonful, according to the age of the 
patient ; judging from its mode of operation in the cases which 
I have used, I am fully satisfied that it contains expectorant 
and antispasmodic properties to a high degree. From my 
observing the effect of this remedy in pertussis and phthisis 
pulmonalis, I was induced to expect advantage from it in 
asthma. I might here, perhaps, be charged with empiri- 
cism, but I beg leave to state that it was not from the effect 
alone, being ignorant of the cause, that induced me to use 
it, but from its expectorant and antispasmodic properties. I 
administered it in one case of dry asthma with very gratify- 
ing effect, and have good reason to believe that if it was fairly 
tested, it would stand as high in the estimation of the profes- 
sion as some foreign drugs which are so highly esteemed in 
treatment of pulmonary complaints. There are several other 
of our indigenous herbs which I have made the subject of my 
investigations, but for want of sufficient opportunities for test- 
ing their virtues, have been obliged to omit them. I would 
state, in conclusion, that in neglecting to investigate the medi- 
cal properties of our indigenous plants, we are overlooking a 
subject of vast importance to the profession, and one which, 
if cultivated, would most undoubtedly promote both the inter- 
ests of science as well as our political, or rather, commercial 
independence. 

Columbus, July 14, 1S51. 



812 STUART ON MEDICAL REFORM. 



A 31onstrosity. By S. Birdsell, M. D. 

Mr. Editor : Thinking that it would not be uninteresting 
to your readers to see the report of monstrosities, even if 
there is no practical advantage attending it, I would state 
that on yesterday morning, the 13th inst., I attended Mrs. 
L, of this place, in her third labor, and in about an hour she 
was delivered of an acephalous monster. 

I was unable to examine the child anatomically, but, in 
place of the skull, there existed a tender and highly vascular 
membrane, under the centre of which there appeared to be a 
mass of doughy consistence, about the size of a hulled walnut, 
along the centre of which I could see the groove which ap- 
peared to separate the two rudimental hemispheres. The 
face was smaller than natural, and the features, except the 
mouth, deformed. The trunk and limbs were perfect and 
well developed, the whole, I would suppose, weighing 9 or 
10 lbs. 

The child died this evening, having lived nearly 48 hours 
after birth. It exhibited convulsive movements when any 
article of clothing irritated the scalp. 

Caxde^, June 14th, 1851. 



Medical Reform. By James H. Stuart, M. D, 

"But yesterday, and physio might have stood against the 
world ; now, none so poor to do her reverence.' 7 Our pro- 
fession is rapidly declining in respectability. This is a very 
bold proposition, but, unfortunately, so self-evidently true, 
that there is no risk of its being disputed. We make great 
boasts of the vast discoveries annually made in the scientia 
medicinoe, of the talent and learning enlisted in its behalf, 
of the wealth expended upon it ? and of its great usefulness to 



STUART ON MEDICAL REFORM. 313 

suffering humanity, and all is true ; yet the stigma still re- 
mains. Year after year we hear more and more of suits for 
malpractice, more instances of gross ignorance in medical 
men, more carping at the writing of prescriptions in Latin. 
We can almost see a sneer of contempt when the profession 
is named. Why is this ? Is it because of the prevalence of 
quackery ? Is it because Thompsonianism, homoeopathy, et id 
genus innumerabile of quack systems have arisen and pinned 
themselves to the skirts of medicine? No. For, though with 
the uneducated vulgar, such association would bring us into 
disrepute, the intelligent man would distinguish and draw the 
line of demarkation. The evil rests with ourselves. We are 
accountable for it. Can it be wondered at that men will des- 
pise a profession containing individuals who, as in a recent case 
published in the papers, write oleum ricini oleum resini, and 
have done so for twenty years ? Oh, time-honored ignorance, 
what hast thou and thy coadjutor — impudence — not done for 
thy votaries ? No wonder the laity call for a reform, and 
because they cannot hope to strike the root of the evil, sug- 
gest the milder one of writing prescriptions in English, thus 
practically saying to us, " You are ignorant asses ; we can- 
not trust you to meddle with a learned language, and will, 
at all events, take pains that your ignorance is not fatal to 
us." This is painful, but it is true. There certainly are 
many in the profession, regularly furnished with their dia- 
plomas (as one of them termed it), who not only are unable to 
write a Latin prescription, but would be sorely puzzled to get 
through an English sentence without the most amusing na- 
tural phonography. Hundreds crowd every year to our 
medical schools who are destitute of the rudiments of a com- 
mon school education, and duly emerge in the spring with 
moustache and parchment, lancets and tight-boots. As 
Burns says — 

" They gang in stirks and come out asses." 

And, on their return, their fellow-townsmen open their eyes 
in astonishment that the lazy Tom, Dick, or Harry, has turned 



314 STUART ON MEDICAL REFORM. 

out "a real doctor." Can we blame them that they do not 
place much confidence in medical men ? Is it not the most 
common thing in the world to hear that some brainless whelp, 
for whom you entertain a perfect contempt, has commenced 
"studying medicine ?" The profession is now far overstocked. 
Every little village contains three times the necessary num- 
ber. At least, one-half now in it must be starved out, yet 
"the cry is still they come." They do come, and they come 
because they well know there is no such thing as failing in 
this profession. Medical colleges are springing up like mush- 
rooms over the country, and if they cannot graduate at one, 
it is the easiest thing in the world to go to another and " be 
put through" there. It is almost enough to make one heart- 
sick to think of the companionship he is subjected to. To 
know that at any moment he may be called upon to recognize 
the professional equality of some ignoramus whom, in society, 
he would never think of noticing ; to feel that you cannot 
travel in peace without hearing the low-looking fellow at 
your elbow styled "doctor" by some gaping ninny who is 
proud of the acquaintance of a "professional gentleman;" 
without seeing some "nice young man" in spectacles, mincing 
along with the gravity of an owl, and carrying under his arm 
the unmistakable red morocco pocket-case. Truly we will 
soon begin to envy the title of plain " Mr." as a distinguish- 
ing mark. And, withal, we have the ladies ! They talk of 
" lovely subjects" and "charming dissections" with a sang 
froid and apparent pleasure that the greenest of first course 
students might well envy. But, alas ! it is no jesting subject. 
Ignorance is fearfully rife among us. The evil would, in 
time, work its own remedy, but we cannot wait. And yet 
what is to be done ? Legislation cannot avail even were the 
legislators willing to assist us, which they are not. Against 
any hint of reform are arrayed the interests of all concerned 
in teaching medicine. Every country doctor who has a pri- 
vate pupil must get his own pet through and receive his fee 
for it; every city physician, with his class of three or four, 
has his interest proportionally increased, and the colleges 



STUART ON MEDICAL REFORM. 315 

are, of course, anxious for as many pupils as they can get. 
Would that medical men had but the honesty to tell appli- 
cants for seats in their offices the candid truth ! To say to 
one, "Your health is too feeble ; you will die under hard 
study;'' to another, "Your mind is unfitted for the profes- 
sion; you will never make a physician;" and, to a third,, 
u Stick to your shoemaking — you can live at that." To let 
them know the troubles and anxieties of the profession, the 
wearing mental toil, the hard bodily labor, the lack of equally 
distributed time, and the inadequacy of the remuneration of 
medical men. Would they do this, we might hope soon to 
see the number of doctors decreasing, and their respectability 
increasing. We would then have only robust men with good 
minds, and men actuated, not by the love of money, but who, 
like Aben Ben Adhem, say — 

" Write me as one who loves my fellow men." 

Men who are willing to undergo suffering and toil, to expose 
themselves to cold and damp, to ingratitude and even poverty 
for the sake of alleviating some of the misery that " flesh is 
heir to." Failing of this mode of purifying the profession, 
another more general one, having reference to examinations 
for practice, should be resorted to. This might be accom- 
plished by the joint consent of the schools, or by action of the 
National Association. But my article is growing longer than 
I had intended, and, for the present, I must cease. Perhaps 
in a future number I may amplify, with your consent, on the 
idea just thrown out. At present, I conclude by quoting 
from an unpublished poem of 0. Wendell Holmes, which acci- 
dentally came under my notice, the following excellent advice 
fco any one thinking of medicine: — 

"But thou, poor dreamer, who hast vainly thought, 
To live by knowledge which thy brain has bought, 
Go, shun the art which every boon denies, 
Till age sits glassy in thy sunken eyes ; 
Go, shun the treasury which withholds its store 
Till hope grows cold and blessings bless no more." 



BIBLIOGRAPHICAL NOTICES 



Quarterly Summary of the Transactions of the College of 
Physicians of Philadelphia, from January 6th to April 
1st, 1851, inclusive. 

This periodical is much improved by its new dress. The 
number before us is the second of the new series. It contains 
several interesting papers, some of which we shall briefly no- 
tice. First, 

Cases of Cheese Poisoning, by Dr. Isaac Parmsh. — Dr. 
P. was called to a family consisting of a laboring man, his 
wife, and six children, all of whom, except the wife, had been 
taken sick within a few minutes of each other, after eating 
their accustomed scanty meal of tea, bread, and cheese, with- 
out anything else. The children were more violently affected 
than the father, their symptoms resembling somewhat those 
of cholera : as severe vomiting, dizziness, great prostration of 
strength, coldness of the extremities, accompanied with pro- 
fuse watery discharges from the bowels. After relieving the 
violence of the symptoms, the Dr. took some of the matter 
ejected from the stomach, to an apothecary, in order to apply 
to it some of the tests for metallic poison, but found no rea- 
son to suspect poison in any of the food. The druggist, on 
learning the facts of the sickness, mentioned that a family 
near by had been similarly affected, on the previous evening, 
from eating cheese from the shop of a neighboring grocer. 
The Dr. now repaired to the family in question, and found 
that those who had eaten of the cheese had all been attacked 
in the same way as his own patients ; and on visiting the 
grocer, from whom it had been obtained, he learned that it 
was one of a large lot from a celebrated New York dairy, was 
but three or four months old, weighed but ninety pounds, and 



BIBLIOGRAPHICAL NOTICES. 317 

was considered a good article. The grocer had sold nearly 
seventy pounds of it within a few days to a large number of 
people, and had retailed out some eight or nine cheeses from 
the same lot, without hearing any complaints from his cus- 
tomers, until within two days, during which time five or six 
families had been taken ill. Those who had eaten of the 
cheese previously, though many of them were found, and in- 
quired of, experienced no inconvenience from its use. A slice 
of the cheese being subjected to an analytical chemist, no 
trace of mineral poison could be found in it ; hence in seeking 
an explanation of this singular phenomenon, the peculiar state 
of the atmosphere was thought of, as a probable source of the 
deleterious properties which seemed to be developed in the 
cheese under its influence; these singular facts having occurred 
during a spell of remarkably damp, foggy, and mild weather, 
succeeding a cold and clear atmosphere in January. During 
the two days in which these cases occurred, the air was loaded 
with moisture, and the fog on the Delaware was sufficiently 
heavy, as to impede the progress of the boats in crossing. 

The cheese, it is suggested, having been previously frozen, 
might, in the process of softening, have developed deleterious 
properties; or that, as often happens under more favorable 
circumstances, the oilv matters contained in it might have 
been converted into an irritating acid, which acted on the 
stomach and bowels in the manner described. 

What strikes us as remarkable, is the fact that the discarded 
portion of the (poisonous) cheese, was afterwards sold out in 
slices by another person, without any unpleasant results, which 
fact seems to confirm the theory that the cause of the offend- 
ing property was atmospheric. Considerable pains having 
been taken by Dr. P. to ascertain the extent of injury from 
this cause, he supposes that not less than one hundred persons 
have been made sick from this cause, under the observation 
of physicians in Philadelphia. But we must close this already 
lengthened notice, by copying from the essay before us, the 
following : " So far as the limited number of observations 
here detailed, will justify any conclusion, we might say first : 



318 BIBLIOGRAPHICAL NOTICES. 

That in all the instances of sickness from cheese poison, the 
cheese has heen mild and newly made. 

" Secondly. That the deleterious properties of the article 
have been developed suddenly in a mass not previously in- 
jurious. 

"Thirdly. That in all the cases the cheese had been exposed 
to the air ; and that in all probability a peculiar state of the 
atmosphere was the immediate cause of the development of 
poisonous properties. 

" If these conclusions be correct, it would seem proper that 
all newly made cheese should be protected from the air, espe- 
cially in damp weather ; and that their too free use as an 
article of food, to the exclusion of more wholesome and sub- 
stantial aliment, should be discouraged." 

Though we have drawn largely from the remarks on the 
subject of cheese poison, on account of their novelty and a 
desire to draw the attention of country practitioners to the 
subject, we cannot well forbear referring to an interesting dis- 
cussion which occurred at one of the meetings of the college, 
on the use of Cod-Liver Oil, in scrofulous affections and con- 
sumption. 

The subject was introduced by Dr. Hays, who stated that 
he had used the oil during the last three years in the Wills' 
Hospital, and private practice, extensively in the various forms 
of scrofulous disease, as it affects the eyes, the external glands, 
the joints, &c, with the most satisfactory results. He con- 
joins, in many instances, the proto-iodide of iron. He had 
tried the remedy in from two hundred to two hundred and 
fifty cases of scrofulous ophthalmia and granular lids, in most 
of which the benefit resulting from its use had been very 
striking. 

Dr. Darrach believed it to be a valuable remedy in the ane- 
mic condition following summer complaint, and scarlet fever ; 
he also mentioned the case of a female with irregular menstru- 
ation, who became thin, pale, and debilitated, with hectic 
fever, night sweats, and cough, who was entirely restored to 
health under its continued employment. 



BIBLIOGRAPHICAL NOTICES. 319 

Dr. Condie considered it more applicable to young subjects 
than to those in whom any tubercular deposits had actually 
taken place ; he had not seen any striking effect from it in 
cases of established consumption. 

Dr. Wood said that he should not be doing justice to his 
own feelings, were he not to communicate to the college the 
information on the subject which he had derived from his 
recent experience. In his late work on the practice of medi- 
cine, he had stated that the only effect he had seen from the 
use of the remedy, was the production of nausea ; but he had 
discovered the reason of this to be in the fact that he had not 
persevered sufficiently long in its use ; and he asserts that 
after having employed it more steadily, he had never met with 
" any one remedy, or combination of remedies, which had 
proved so efficacious as this, in pulmonary phthisis." And 
several remarkable cases were related by the Dr., illustrative 
of the extraordinary value of this remedy. Dr. Patterson 
added his testimony in its favor ; though he had found many 
persons who had imbibed an uncontrollable disgust for it, on 
account of the nausea which it excited. We consider the 
opinions on this subject, of which we have attempted to give 
a synopsis, highly valuable to the profession, and hope they 
will prove acceptable to our readers. In addition to the ob- 
servations referred to, we notice the remarks of Dr. Hays on 
amaurosis and granular disease of the kidneys, of Dr. Evans 
on electro-galvanism in narcotism, the history of a case of 
membranous croup, by Dr. Griscom, and the views of Dr. Neill 
on temporal ridges of the African cranium, &*c, &c* 



320 BIBLIOGRAPHICAL NOTICES. 



Lectures on the Eruptive Fevers, as now in the course of 
delivery at St. Thomas' Hospital, in London, by George 
Gregory, M.D., Fellow of the Royal College of Physicians 
of London, Physician to the Small-Pox and Vaccination 
Hospital at Highgate, Corresponding Member of the Na- 
tional Institute of Washington, etc. First American 
edition, with numerous additions and amendments by the 
author, comprising his latest views, with notes and an ap- 
pendix, embodying the most recent opinions on Fxanthe- 
matic Pathology, and also statistical tables and colored 
plates, by H. D. Buckley, M. D., Physician of the New 
York Hospital, Fellow of the New York College of Physi- 
cians and Surgeons, etc. etc. New York, S. S. & W. 
Wood, publishers, 261 Pearl St. 

Our acknowledgments are due to the publishers for this 
valuable work. It is a large octavo volume, pp. 374, and 
embraces an amount of information that cannot fail to be 
useful to the medical student, and physician. Dr. Gregory's 
connection, for a score of years, with the Small-Pox and 
Vaccination Hospital at Highgate, has given him an oppor- 
tunity for clinical observation which but few enjoy, and the 
result of which is laid before the reader in a plain and familiar 
style. The high position of the author claims a great degree 
of credit and authority for his opinions relative to the febrile 
exanthemata, and, we doubt not, they will be sought after by 
those who wish to keep pace with the current history of this 
class of diseases. The character and affinities, the manage- 
ment, early history, phenomena, and pathology of the erup- 
tive fevers, with statistics and extended remarks on non- 
contagious efflorescences, are set forth in thirteen lectures, to 
which is added, by the American editor, an appendix, con- 
taining statistics of small-pox, measles, scarlet-fever, and 
hooping-cough, in the cities of New York, Philadelphia, 
Boston, Providence (R. I.), Lowell (Mass.), Baltimore, and 
Charleston (S. C), and in the State of Massachusetts, as far 



EDITORIAL. 321 

as could be obtained. There are also added to the work four 
colored plates of the vaccine disease, as it appears in the cow, 
and on the hands of those inoculated from this source. The 
first of these represents the casual cow-pox at its acme on the 
teats and udder of the cow; and the three others, the vaccine 
vesicles on the thumb and finger of the milker on the fourth, 
ninth, and tenth days of papulation. The typographical 
appearance of the work is good — better than we frequently 
see from the American press. We have not space for a more 
extended notice, but we can safely recommend " Gregory on 
Eruptive Fevers" to our readers as a work worthy of their 
possession. 



EDITORIAL. 



"Professors and Laymen." 

The letter which appeared in our last number from Br* 
Yardley, of Philadelphia, correcting an erroneous impression 
which exists with regard to the motive of the authors of the 
resolution to which he refers, seems to demand of us a passing 
notice* The resolution was presented at the late meeting of 
the American Medical Association at Charleston, S. C, and 
proposes an alteration in the constitution of the Association^ 
which, if adopted, would rescind that provision of it, by which 
delegates from all medical colleges, hospitals, lunatic asylums, 
&c, are admitted. As this is still an open question, we feel 
at liberty to say a few words upon the propriety of adopting 
the resolution which emanated from the Philadelphia County 
Medical Society, It is as follows t " Resolved : that the con- 
stitution of said Association should be altered so as to admit 
only delegates from county or state medical societies." We 
conceive that great good would result from such an arrange- 



322 EDITORIAL. 

roent, inasmuch as it would inspire a greater interest in the 
mass of the profession to form themselves into county and 
state medical societies; there being no means that can be 
adopted for the mutual improvement of physicians, both in 
their professional and social capacity, that can be compared 
in importance to such organizations ; and while a great good 
would be accomplished in this way, and a stimulus given to 
medical reform, the unequal representation now complained 
of would be avoided, and the meetings of the Association 
conducted on those principles of republican equality which 
belong to the genius of our country. There does not seem 
to us a single valid reason why the representation from 
medical schools, hospitals, &c, should be three times greater 
than that of the whole profession ; and we do not believe that 
the jealousies which have already poisoned the current of har- 
mony that is wont to refresh and invigorate the entire body, 
are in anywise necessary to the maintenance of the associa- 
tion ; hence we would be glad to see them all abandoned ; and 
as we believe their foundation is in the spirit of rivalry be- 
tween the different schools, and of suspicion between those 
who are professors, and those who are not, we would rejoice 
to see the wall of partition broken down. 

Medical schools generally spring up as the result of private 
enterprise, organized and sustained in view of personal emolu- 
ment ; and they ought not to be allowed, in matters of com- 
mon interest, to exercise an unequal and overbearing influence. 
We do not charge those to whom they belong, with any motive 
of injustice towards others ; but we do believe that in a 
general assembly of physicians, met together from all parts 
of our country, for the purpose of improvement in science, 
and the advancement of mutual interests, there should be no 
line of difference drawn between professors and laymen ; and 
that there should be no doctrines taught that may be arrayed 
before us as school, or anti-school. That there is such a spirit 
among us, is evident. The very fact of the resolution itself, 
confirms the assertion. The great cause of dissension in the 
medical world (not as regards opinions in practice), but as re- 



EDITORIAL. 823 

lates to the policy and government of medical organizations, 
and professional intercourse with each other, is jealousy; that 
strong passion of the human heart, which arises from fear that 
a rival will gain an advantage which we had hoped to gain, or 
that he may be exalted to a position which we had anticipated. 

That this spirit may be rooted out of our noble, and enno- 
bling profession, we do most heartily desire ; because, wherever 
it may be found, in the private walks of daily professional 
life, or in our more public engagements connected with medi- 
cal societies, it is the spirit of discord. It must be avoided, 
if we would have prosperity; and if we would hide it from 
the sight of the multitude in our public meetings, we must hide 
it from one another in our daily life ; and let the tribute of 
gratitude be freely offered to those, who, with a strong desire 
to serve the profession and the cause of science, have come 
forward with a suggestion which promises so much benefit. 
To them let the language be addressed, 

" Whoever has qualities to alarm our jealousy, has excel- 
lence to deserve our fondness.'' 

We hope the question involved in the resolution will be fully 
considered. It does not contemplate to exclude professors 
from the meetings of the association, but to do away with all 
exclusive privileges, while it equalizes the legislative power 
of what ought to be, our medical congress. 

Professorial Changes. 

Professors Webster and Coventry having resigned their re- 
spective chairs in the Buffalo Medical College, the former has 
been succeeded by Prof. B. R. Palmer, of Woodstock, Yt., in 
the chair of Anatomy, and the latter by Dr. John C. Dalton, 
Jr., of Boston, in the chair of Physiology and Medical Juris- 
prudence. 

Professor Cfross having resigned the professorship of Sur- 
gery in the University of New York, Dr. Alfred C. Post has 
been appointed to fill it, and Dr. Meredith Clymer, of Phila- 
delphia, has been appointed to the chair of Medicine in the 



324 editor's table. 

same school, vacated by Prof. Bartlett. Prof. Gross resumes 
his former position in the Louisville Medical School. 

Professor P. R. Peaslee, of Hanover, 1ST. H., has been ap- 
pointed professor of Physiology, Pathology, and Microscopy, 
in the New York Medical College. 



EDITOR'S TABLE. 

The following pamphlets, journals, &c, have been re- 
ceived : — 

Report on the Eastern Lunatic Asylum in the city of Wil- 
liamsburg, Va., for 1850, and 

Essays on Asylums for Persons of Unsound Mind. By 
John M. Galt, M. D., Superintendent and Physician of the 
above Asylum. These are able and interesting essays, which 
are, in fact, reports which were presented to the Association 
of Medical Superintendents of American Institutions for the 
Insane, at the meeting of the society, which took place in 
June, 1850. 

Professor DarracK s Charge to the Graduating Class of 
the Medical Department of Pennsylvania College, contains 
many counsels which are of vast importance in the formation 
of the medical mind. His subject is divided into — liberality, 
devotion, compassion, and discernment — as necessary qualifi- 
cations in the practitioner of medicine. 

A Neiv Sign Language for Deaf Mutes. From the author, 
Albert J. Myer, M. D., Buffalo, N, Y. A very ingenious 
and original paper. 

An Address on MedicalJurisprudence. By D. H. Storer, 
M. D., of Boston, awaits a more extended notice. 

American Journal of the Medical Sciences. 

British and For. Medico-Chirurgical Review. 

American Journal of Insanity. October and January not 
received. 

American Journal of Dental Science. 



editor's table. 325 

Transactions of the College of Physicians, Philadelphia. 

Transactions of the New York Academy of Medicine. 

American Journal of Pharmacy. 

New York Journal of Medicine and the Collateral Sciences. 

Charleston Medical Journal and Review. March No. not 
received. 

Ohio Medical and Surgical Journal. 

New Orleans Medical and Surgical Journal. Not received 
since November. 

St. Louis Medical and Surgical Journal. 

Transylvania Medical Journal for June. 

Medical Examiner. 

Stethoscope and Virginia Medical Gazette. 

Southern Medical and Surgical Journal. 

Northern Lancet. 

Western Lancet. 

British American Medical and Physical Journal. June 
and July not received.. 

Buffalo Medical Journal. 

Medical News and Library. 

Nashville Journal of Medicine and ' Surgery. February 
only received. 

Dental News Letter. October, January, and April only 
received. 

Mrs. Whittelsey's Magazine for Mothers and Daughters, 
New York. 

New York Register of Medicine and Pharmacy. 

New York Medical Gazette. 

Boston Medical and Surgical Journal. 

North Western Medical and Surgical Journal. 



vol. iv. — 26 



ECLECTIC AND SUMMARY DEPARTMENT. 



Poisoning from Opium successfully treated by Electro- 
Magnetism. — Two cases of the successful employment of 
electro-magnetism, in poisoning from opium, are reported in 
the Philadelphia Medical Examiner for June, one by Dr. J. B. 
Biddle, one of the editors of the Examiner, the other by Dr. 
Mutter. Both cases seemed desperate, having failed to yield 
to the usual modes of treatment resorted to on such occasions. 
One pole of the battery was applied to the nape of the neck, 
the other to the epigastrium and other parts of the body. In 
Dr. Biddle 's case, it was necessary to keep up the action for 
more than two hours, as the patient sank back into a state of 
profound coma when the poles of the battery were withdrawn. 

Syncope after Delivery. — Dr. Saml. C. Wait, of Gouver- 
neur, N. Y., recommends the compression of the abdominal 
aorta in cases of faintness after delivery. This is easily 
accomplished by pressure at the umbilicus in the lax con- 
dition of the abdominal parietes after delivery. This com- 
pression may be kept up until stimulants have time to act. 
It is also spoken of as an effectual way of arresting uterine 
hemorrhage. — Boston Medical Journal. * 

In the Reporter, for May, we gave a summary of an article 
in the Boston Medical Journal, by Dr. Shipman, of Syra- 
cuse, N. Y., in which he recommends morphia in the treat- 
ment of strangulated hernia. In the same journal, for June 
11th, is an excellent article on the 'principles involved in the re- 
duction of hernia, by Dr. Geo. J. Ziegler, of Philadelphia. His 
prominent ideas seem to be the relaxation of the external, or 
constricting tissues, by appropriate means, and the contrac- 
tion of the internal tissues involved, by the use of astringents. 



ECLECTIC AND SUMMARY DEPARTMENT. 327 

According to Dr. Z. ? the true indications to be fulfilled 

appear to be — 

" First — The prevention or correction of the irritation both local and 
general, and, consequently, the baneful effects of the continuance of 
such, which may be furnished by the internal exhibition of full and 
frequent doses of opium, or its salts, &c. Second— The contraction of 
the intestinal and strangulated tissues, and thus to withdraw them 
through the confining part into the abdominal cavity. This may be in- 
duced by astringents, such as acetate of lead, tannin, &c. ; the former, 
in addition to its astriugency, exerting a sedative, and thus promoting 
its former action, while it is, at the same time, assisting the sedative 
and astringent influence of the opium for the former indication, as it is 
a well-established fact that this latter produces constipation, which may 
not, however, depend altogether upon its astringent, but its stimulant 
or sedative and desiccative influence on the tissues and secretions, thus 
modifying the hygrometric condition of the mucous and other mem- 
branes. Third — Position, which should be such as to promote the 
relaxation of the abdominal and other muscles and tissues concerned in 
the constriction of the protruded part. Fourth — The more immediate 
correction of the irritation, and the induction of relaxation of and about 
the confining tissues. These may be produced by the external applica- 
tion upon and around the tumor of warm water, warm infusions of bella- 
donna, stramonium, &c. or, probably, better still, by solutions of their 
active principles, atropia, daturia, &c. ; or, where none of these are 
convenient, the leaves of these plants, or those having analogous pro- 
perties, as tobacco, &c. ; but this latter is so readily absorbed, and 
so powerfully and directly sedative, that if used indiscriminately 
even here, it may interfere with the successful action of the internal 
remedies. Fifth — The taxis, the pressure from which should be very 
gentle, yet steady and prolonged. Sixth — After the reduction, the 
evacuation of the alimentary canal. This, however, is sometimes spon- 
taneous ; but if not, it can generally be effected with little difficulty by 
injection or otherwise of mild and soothing cathartics, such as castor 
oil, &c. These are preferable, because the tendency is still, if it is not 
already active, to inflammation, and, therefore, should be carefully 
guarded against, even to the exclusion of catharsis for a time if the 
tendency or action should be very strong, although in this stage, from 
the modified condition of the intestinal membranes, inflammation may 
arise and depend upon the faecal accumulations. Hence it requires 
judicious discrimination. Seventh — The prevention and cure of inflam- 
mation and its consequences by the usual antiphlogistic treatment, 
according to the stage and activity of the disease, and the characteristic 
tendencies of the patient's system. 

Scutellaria Laterifolia as a Nervine. By C. H. Cleaveland, M. D., 
of Waterbury, Vermont. — One of the most valuable nervines that have 
been discovered for our use, is to be found by the side of many of our 
streamlets, and in low marshy places in nearly every part of this State, 
and in sufficient quantities to supply the entire profession from Maine to 
Texas, should they but be convinced that with us grow plants possessing 
medicinal properties as useful and as potent as are obtained from dis? 
tant climes. 

Such, I think, must be the belief of all who will make a trial of the 
Scutellaria Laterifolia, in the place of the English or German Valerian 



828 ECLECTIC AND SUMMARY DEPARTMENT. 

(Valeriana officinalis), that has been the main article in use in this 
region in all nervous diseases since the day when Assafoetida went out 
of fashion. 

The Scullcap has not only a most remarkable power of controlling 
the nervous excitability, as manifested in patients of an irritable tem- 
perament when fatigued, over-excited, or suffering from slight physical 
derangement, but its most valuable properties are displayed in those 
severe and painful cases where we are led to use our most potent and 
active remedial means. In Delirium-tremens, Tic-douloureux, Convulsions 
from irritation of the ganglionic nerves or spinal cord, in Chorea Sancti- 
viti, dental irritation among children, as well as in the ordinary diseases 
of the nerves, where a soothing quieting medicine is indicated, I have 
been led to prefer the Scutellaria above all other nervines or antispas- 
modics, except in those cases where an immediate effect is desirable. 
In such cases, of course, we should resort to chloroform, ether, musk, 
castor, and the other drugs of the same class. 

Among my reasons for this preference, I would mention the tonic 
property of the herb, which gives strength as well as quiet; its su- 
dorific and its diuretic powers, both tending to relieve the congestion 
that is usually present, which tends to perpetuate the disease. It never 
leaves that excitable irritable condition of the system when its soothing 
influence has worn away, that follows some of the other nervines ; and 
it is so readily administered that but little delay need occur, and no 
evil results be anticipated. 

I am led to call the attention of the profession to this plant in the 
earnest and decided manner I have used, mainly because of the high 
estimate I place upon it ; but in part from the disparaging remarks of 
the United States Dispensatory. I would not wish to detract from the 
fair and just fame of the compilers of that great work, or lessen the con- 
fidence that is so properly placed in it, but I think I know more of this 
plant than those authors could know, and write according to my own 
observations. AVithout doubt, the plant has been extolled too highly 
by some, and also recommended in cases where it has failed of answering 
the expectations of those who relied upon it, but not, I think, when 
used in such diseases as are indicated above. To me it has never seemed 
inert and powerless, and having had occasion to make personal use of 
it when the whole system was suffering severely from being poisoned 
by decomposing animal matter, I feel qualified to testify that "it does 
produce an obvious effect." 

I have used it in the form of a saturated tincture, a syrup, and a cold 
and warm infusion; and I prefer the infusions to the other preparations 
when they can be conveniently prepared, the cold when it is desirable 
to obtain the tonic, and the warm when the sudorific effect is demanded. 
Half an ounce of the dried leaves to a tea-cup full of water will be very 
strong, and it may be drank ad libitum. 

Of its curative power in cases of hydrophobia I can say nothing, never 
having had an opportunity to give it a trial ; but should such a case 
present itself, I should make a trial of the plant in conjunction with 
other means.* — N. Y. Register. 

Sanitary Institutions. — The progress of modern medicine is, perhaps, 
nowhere better shown than in what may be termed the sanitary feature 

* See " Treatment of Hydrophobia," by Dr. Moran, in N. J. Medical Reporter 
for October, 1850, p. 39.— [Ed. N. J. Med. Rep. 



ECLECTIC AND SUMMARY DEPARTMENT. 329 

of the science. By this expression we mean to refer, not alone to 
public and private hygiene, but to the class of measures involved in the 
management of diseases which may be called sanitary, in distinction 
from those which are medicinal in their character. A nicer discrimina- 
tion in the cases which call for the active interference of medical aid ; 
a greater reliance on the conservative and restorative energies of the 
organism ; and, in proportion to an increased circumspection in the 
* use of medicinal agents, a juster appreciation of sanitary treatment, 
may be said to characterize modern therapeutics, as exemplified in the 
practical views of the best practitioners of the present time. 

As one of the results of the present tone and tendency of practical 
medicine, we hope to see institutions established under the auspices of 
the profession, in which the sanitary, as well as medicinal treatment of 
chronic affections, may be more systematically and faithfully conducted 
than is, in many cases, practicable in private practice. We have for 
some time entertained the belief that the absence of sanitary retreats, 
or rather their relinquishment into the hands of empirics, is a misfor- 
tune which ought not to exist. Such institutions, placed under the 
supervision of well educated, experienced, judicious physicians, would 
do a great deal of good, and, by providing for an obvious necessity for 
them, would protect many persons from the delusions of quackery. 
There is a certain class of patients requiring the hygienic discipline of 
institutions of the description referred to, where the benefits of with- 
drawal from the cares and excitements of business ; the moral influences 
of novelty, recreation, and change of scene ; together with properly re- 
gulated habits of diet and regimen, and such special sanitary measures 
as may be indicated, are conjointly brought to bear on the recovery of 
health. We need not stop to describe the class of patients to whom we 
allude, for there is not a medical practitioner actively engaged in the 
duties of his profession who cannot at once recall instances to be met 
with in his daily walks. This class of patients, as every physician's 
experience tells him, cannot be cured by drugs alone. Different reme- 
dies are prescribed in succession, until the physician and patient 
become tired, and often separate in mutual disgust. It is by this class 
that patented remedies are consumed, and empirics of all kinds are, in 
a great measure, supported. As a general remark, the difficulty in such 
cases, in the way of cure, consists in certain physical, mental, or moral 
obstacles that cannot be removed except the patient be placed under 
circumstances in which the influences acting in these three directions, 
severally and collectively, can be effectually controlled, and this can 
only be done at well-regulated sanitary retreats. 

Hitherto such institutions have been mostly in the hands of irregular 
practitioners, and are conducted with reference to some exclusive dogma. 
Hydropathy is the prevailing basis at this time, and nearly all the 
public institutions for the restoration of health are water-cures, gene- 
rally under the management of homoeopathists, Thompsonians, and 
eclectics, or uneducated persons who do not belong to any medical sect, 
but are a " law to themselves." The fact that these establishments are 
crowded with inmates, shows the existence of a want which it is the 
duty, not less than the true policy of the profession, to supply. If 
there were proper institutions placed under the supervision of physicians, 
and conducted in a manner to meet the approval and encouragement 
of the profession, it is probable that they would be preferred by a large 
majority of the patients who now flock to those which cannot and should 
not be recognized as within the pale of legitimate practice. Hence, a 



330 ECLECTIC AND SUMMARY DEPARTMENT. 

much greater amount of good would be effected, in the first place, by 
giving better advantages to the individuals for whose benefit sanitary 
institutions are designed ; and, in the second place, by providing against 
the encroachments of quackery. So long as the profession continue to 
relinquish this field of practical medicine, it will be occupied by those 
who now have possession of it, and who are shrewd enough to perceive 
and profit by its fruits. The profession in this, as in some other mat- 
ters, has been neglectful of its own interests, and allowed squatters to 
remain unmolested until they are emboldened to prefer a pre-emption 
claim to valuable territory belonging rightfully to legitimate medicine. 

That sanitary institutions would give efficiency to the management 
of a large number of chronic cases which are now the opprobria of the 
profession, may be deduced from the fact that beneficial results are 
attained at the establishments professedly of that character which now 
exist. We freely admit this to be a fact, while it is not less certain 
that, owing to errors and defects arising from ignorance, want of judg- 
ment and discrimination, and the adoption of exclusive and erroneous 
doctrines of therapeutics, much harm is done. The failures and in- 
stances of positive injury probably preponderate greatly over the 
aggregate of cases in which cures are effected, or real benefit is expe- 
rienced. But let sanitary retreats be instituted, in which, as in our 
insane asylums and hospitals, patients can enjoy the advantages of 
medical knowledge, experience, and skill, and while the amount of good 
would be immeasurably enhanced, there would be no counterbalancing 
evils. 

"We have penned these few remarks in order to invite the attention 
of our readers to a subject which seems to us to possess considerable 
importance, and to which we may recur at some future time. — Editorial 
in Buffalo Journal. 

Medical Facts. — The first permanent hospital was established in 
Philadelphia in 1752, and was aided by a grant of £2,000 from the 
Colonial Assembly. Its establishment was owing to the suggestions 
of Dr. Thomas Bond, who became its superintendent, and, we believe, 
the first clinical lecturer on medicine in America. 

The first medical school was commenced in Philadelphia in 1768, 
which was closed during the Revolution. 

The first medical degrees conferred in America were by King's Col- 
lege, New York, in 1769. 

The first medical work was " A Brief Guide on Small-pox and 
Measles," by Thomas Thatcher, of Massachusetts, published 1G77. 

Dr. Zabdiel Boylston, of Boston, first introduced the practice of in- 
oculation for the small-pox into the country, by inoculating his own 
son, thirteen years of age, and two colored servants. This was on the 
27th of June, 1721, only two months after the inoculation of the daugh- 
ter of the celebrated Lady Wortley Montague, the first that was prac- 
tised in England, and certainly before any knowledge of the latter case 
could have reached Boston. Dr. Beekmann Van Buren, as physician 
to the Alms House, was the first physician, says Dr. J. W. Francis, who 
introduced the practice of inoculation for the small-pox into our (New 
York) public institutions. 

The first post-mortem examination that took place in America, of 
which we have any record, was made in 1691, by Dr. Johannes Kerf byl, 
assisted by five other physicians of the city of New York. The body 



ECLECTIC AND SUMMARY DEPARTMENT. 331 

was that of Governor Slougter, who died suddenly under suspicious 
circumstances. 

The first medical meeting was held in New Brunswick, N. J., in 
1766. 

In 1781 the Massachusetts Medical Society was incorporated, being 
the first medical society formed in America. 

The first medical periodical published was commenced in New York 
in 1796, and called the Medical Repository. — New York Literary World. 

Destruction oftlie Foot by Fire during Ancestlietic Intoxication by Spts. 
of Turpentine — Amputation below the Knee. — This is also a case of burn, 
but under singular circumstances. The negro Reuben, aged about 60 
years, had long been in the habit of indulging too freely his appetite 
for stimulants, and had of late resorted to the use of spirits of turpen- 
tine when he could not procure the more palatable combinations of 
spirits of wine. The festivities of Christmas week had furnished him 
a liberal supply of alcoholics, when, on the evening of the 30th Decem- 
ber, he added a full potation of spirits of turpentine, and went to sleep 
upon the floor with his feet near the fire, as is very common with this 
class of people. On the following morning his fellow servants found 
him still soundly asleep, with one foot upon the burning wood, his shoe, 
stocking, and the lower end of the pantaloons having been entirely 
consumed. He was aroused, and walked out to urinate, saying that he 
felt no pain in his foot, and that he did not believe it was burnt. On 
returning into the house, he took another drink of the turpentine and 
went to bed. The patient being in Hamburg, Dr. Creighton was called 
to see him, and requested Prof. Dugas to meet him in consultation at 
noon on the 31st. The old man was found asleep, but was easily 
awakened, when he still denied having any pain in the limb. The 
surface of the foot and leg, half way up to the knee, was completely 
charred, and the deep seated parts felt as though they had been tho- 
roughly desiccated. No sensation was experienced on plunging a knife 
into the affected tissue, although he felt it when carried above. 

As it was deemed proper to await the subsidence of the effects of the 
intoxication before proceeding to amputate the limb, this was deferred 
until the 3d January, when it was removed a little below the knee. 

The chloroform did not in this case induce the comatose state, al- 
though it was very freely inhaled. It simply produced intoxication ; yet 
insensibility was so complete that the amputation was effected during 
his conversation with the bystanders, and without his knowledge, for 
he was quite surprised when informed that the foot held up to his ob- 
servation was his own. Prof. Dugas states that he has repeatedly 
observed that it is very difficult to produce the comatose effects of anaes- 
thetics in persons addicted to intemperance. 

On examining the amputated extremity, it was found that the tissues 
of the foot and leg, up to about three inches below the section, were 
completely dried, and resembled jerked or smoked beef. Above this 
they were tumid and infiltrated with serum. 

An opiate was given Reuben at bedtime, but he passed a very rest- 
less night, being much annoyed with strangury, and seeming still 
somewhat intoxicated. On the following day he evinced symptoms of 
approaching mania-a-potu, with occasional hiccough. Alcoholics, opi- 
ates, and broth, were administered ; he seemed to improve a little, but 
as the strangury subsided, he became troubled with incontinence of 
urine : mania-a-potu was not developed, but he remained flighty ; the 



332 ECLECTIC AND SUMMARY DEPARTMENT. 

hiccough increased, his appetite failed, the energies of the system gradu- 
ally sank, and he died on the 13th January, the stump having only 
partially healed. 

This case is remarkable ; it illustrates the extent to which the taste 
maybe depraved by intemperance ; it establishes the new fact that spirits 
of turpentine may induce complete insensibility ; and it shows the 
serious and persistent deleterious effects of this agent upon the urinary 
apparatus as well as upon the general system. Reuben never appeared 
to be entirely relieved from the intoxication during which he was 
burnt. — Southern Med. and Surg. Jour. 

Blanched Hair from Sudden Emotions. — Dr. Smilie relates the follow- 
ing case among others in the Boston Medical and Surgical Journal for 
July 2d. The subject of it was a young man 23 years old : — 

" He came from the mines to San Francisco with the intention of 
soon leaving the latter place for home. On the evening of his arrival, 
he, with his companions, visited the gambling saloons. After watching 
for a long time the varied fortunes of a table supposed to be undergoing 
the process of ' tapping/ from the continued success of those betting 
against the bank, the excitement overthrew his better judgment, and 
he threw upon the ' seven spot' of a new deal, a bag which he said con- 
tained 1100 dollars — his all, the result of two years' privation and hard 
labor — exclaiming, with a voice trembling from intense excitement, 
'my home or the mines.' As the dealer slowly resumed the drawing 
of his cards, with his countenance livid from fear of the inevitable fate 
that seems ever attendant upon the tapping process when once com- 
menced, I turned my eyes towards the young man who had staked his 
whole gains upon a card, and never shall I forget the impression made 
by his look of intense anxiety as he watched the cards as they fell from 
the dealer's hands. All the energies of his system seemed concentrated 
in the fixed gaze of his eyes, while the deadly pallor of his face bespoke 
the subdued action of his heart. All around seemed infected with the 
sympathetic powers of the spell— even the hitherto successful winners 
forgot their own stakes in the hazardous chance placed upon the issue 
of the bet. The cards are slowly told with the precision of high- 
wrought excitement. The seven spot wins ! The spell is broken ; 
reaction takes place. The winner exclaims, with a deep-drawn sigh, 
' I will never gamble again/ and was carried from the room in a deep 
swoon, from which he did not fully recover until the next morning, 
and then, to know that the equivalent surrendered for his gain was the 
color of his hair, now changed to a perfect white !" — Boston Journal. 

Creasote in Diarrhoea. By W. B. Kesteven, Surgeon. — The value of 
creasote in diarrhoea is really so great, and yet it is so little known to 
the profession generally, that if you can spare the space to insert the 
following remarks, they may, perhaps, be of use to others. 

In the year 1849, Mr. Spinks, of Warrington, wrote through the 
medium of your journal to say that he had found the administration of 
creasote in diarrhoea and cholera attended with the best success. The 
writer made trial of the remedy on Mr. Spinks' recommendation, and 
since then has seldom had recourse to any other medicine for diarrhoea. 
In most cases this alone has been given, and chalk mixtures, &c. &c. 
have been entirely discarded. The form in which it has been admin- 
istered to adults has been as follows: R. Creasoti rr\J ad TTLv ; Spir. 
Ammon. Arom. tt\,xv ad gj ; Aquce oj ac ^ Siss. Where pain has been 



ECLECTIC AND SUMMARY DEPARTMENT. 333 

severe, Tinct. Camph. Co. has been added. Mr. Spinks* prescribed 
chloric ether ; but, the writer having had reason to think it produced 
headache, has omitted that article without detriment. 

In no single case has creasote failed to be of signal benefit ; in most 
cases one single dose has sufficed to arrest the course of the disease ; 
in very few cases has it been requisite to administer more than the 
second dose. The remedy has been tried (to keep within the limits), 
it may be stated, in considerably more than a hundred instances, and 
its effects can therefore be confidently affirmed. It is not, of course, 
hereby asserted that equal success will always attend its use ; the cir- 
cumstances of local influences, epidemic constitution of the season, &c. 
may modify results in other hands. The present communication goes 
no farther than to affirm that the writer, like Mr. Spinks, has found 
creasote more efficient than any other drug in stopping pain, vomiting, 
and purging, as combined in diarrhoea. Of its utility in cholera the 
writer has had no experience. 

Creasote is well known to have a powerful effect in coagulating albu- 
men and other animal principles ; and it is probable that its astringent 
operation may be due to the exertion of some such influence on the 
lining membrane, as well as the mucous secretions of the alimentary 
canal. — London Medical Gazette. 

A Case of Insanity cured by Chloroform. By Asahel 
Clarke, M. D., of Beloit, Rock County, Wis. — On the 
evening of the 19th of March last, I was called to see 
Mrs. F., aged 49. For two or three months previous to 
this time, she had been gloomy and desponding. During the 
day a letter had been received from California, containing 
unpleasant intelligence. Several hysterical convulsions fol- 
lowed. She had recovered from these when I arrived, but 
appeared to be insane. I could not persuade her to take 
any medicine, and left, advising her attendants, if she did not 
get sleep during the night, and was not in her right mind in 
the morning, to send for her husband. (Mr. F. had gone to 
the County Seat as a juryman.) 

He was sent for, and the family physician also (a homceo- 
pathist). Ten days after, I was requested to see her again. 
She has had but little sleep, and has continued to be entirely 
insane ever since my last visit. I advised the use of chloro- 
form. Mr. F., after making many objections, consented to 
have it given. I gave it till it produced quiet sleep, and left, 
giving directions to have the room kept still till she awoke. 
She slept about twenty minutes after I left her, and awoke 
quite rational, and has continued so ever since. After she 
awoke, she commenced talking about matters that occurred 
during the day of my first visit. The ten days that had 

# Medical Gazette, N. S. vol. ix. p, 255. 



334 ECLECTIC AND SUMMARY DEPARTMENT. 

elapsed since, were wholly lost time to her. She has no re- 
collection of anything that occurred during that time. 

If you think the above, or any part of it, would be of in- 
terest to your readers, you are at liberty to publish it. — 
iV. W. Med. and Surg. Jour. 

Two Cases of Nervous Collapse after Parturition. By 
C. K. Winston, M. D., of Nashville, Tennessee. — Mrs. 
A. was taken in labor, with her fifth child, some time 
during the autumn of 1844. She was a lady of delicate 
constitution, highly nervous temperament, was in the seventh 
month of pregnancy, and was, at the time, the subject of 
considerable pulmonary irritation. As the full period of 
utero-gestation had not been accomplished, I made some effort 
to arrest the labor, which proved ineffectual, and at one 
o'clock A. M., the child, with the membranes and placenta, 
was forcibly and suddenly expelled. The abdominal tumor 
was unusually large, and a quantity of water escaped with 
the child, which was still-born. 

As soon as the contents of the uterus were removed, I 
placed my hand on the abdomen and found the womb firmly 
contracted. The patient was cheerful for a few minutes, and 
all seemed to be well ; but it was not long before she com- 
plained of "a sinking," as she termed it, which I took for 
ordinary syncope. The womb was immediately examined 
and found still contracted firmly. I then lowered her head, 
threw some cold water in her face, gave a large draught of 
brandy, and made firm pressure upon the abdomen. The 
pulse, in the mean time, had become very feeble and rapid, 
the skin was cold, countenance haggard, respiration quick 
and difficult. I became satisfied that the case was unusual, 
and that, unless something was accomplished speedily, it 
would terminate fatally. The portions of brandy were in- 
creased, powerful pressure was made upon the abdomen, and 
sinapisms, with hot bricks, were applied to the extremities. 
I resorted also to the use of ergot, with the hope of arousing 
the nervous energy by exciting uterine contraction. These 
remedies, however, failed entirely, and I requested a consulta- 
tion with Dr. Felix Robertson. 

When the Dr. arrived, which was about 3 o'clock A. M., 
his first impression was that she was sinking from internal 
hemorrhage ; but there was none externally, and the womb 
was firmly contracted. At this time the patient was very 
restless, the pulse almost extinct, the skin cold and bedewed 



ECLECTIC AND SUMMARY DEPARTMENT. 335 

with perspiration, breathing laborious and hurried. She 
could not lie still — said she should suffocate — complained of 
an unusual tired sensation between the shoulders. The most 
powerful stimulants were resorted to without effect, and she 
expired between 4 and 5 o'clock A. M. 

In the month of January, 1851, 1 was called to attend Mrs. 
G., in labor with her fourth child. I had been with her on 
two occasions previously. In her first confinement, as well 
as the second, she was the subject of adherent placenta. 
There was no difficulty in the third instance, and as her gene- 
ral health had greatly improved, I felicitated myself that in 
this I should meet with no obstacle. The labor became 
active at about 8 o'clock P. M., and at 10 P. M. she was 
delivered of a large healthy female child. In a few minutes 
violent contractions of the womb came on, and the placenta 
was expelled. As soon as this had occurred, the patient 
observed that she was fainting. An examination of the 
abdomen proved the uterus firmly contracted, and I hoped 
that stimulants would soon revive her. In this, however, I 
was disappointed. Dr. Ford was then called in. We con- 
tinued to make the most powerful efforts, as in the former 
case, but without effect, and at 6 o'clock A. M. she expired. 

The above are the only cases of a similar character which 
have come within my observation. They are invested with 
peculiar interest, both on account of their rarity and obscurity. 
Medical writers, so far as I have seen, refer to the condition 
incidentally. They fail to attach the importance to it which 
it unquestionably demands, llamsbotham devotes a para- 
graph or two to it, under the head of " Syncope ;" but surely 
it is widely different from that condition as it is usually 
understood. It is as different from ordinary fainting as is 
the collapse from cholera. It involves a peculiar state of the 
nervous system, and the mode of relief is not understood. It 
is similar to that which occurs in the last stages of congestive 
fever and cholera, and the treatment by stimulants, though 
clearly indicated, are equally unsuccessful. It seems, in such 
cases, that there is a sudden demand made upon the nervous 
centres, by a sudden withdrawal of the stimulus of distension, 
and that in the effort to supply it the vital powers are so far 
exhausted as to result in a nervous collapse incompatible with 
the healthy functions. Or, in other words, there is such an 
exhaustion of the nervous power as that the amount distri- 
buted to the nervous organs is not sufficient to continue them 
in the performance of their appropriate offices. 



336 ECLECTIC AND SUMMARY DEPARTMENT. 

If this view of the subject be correct, it follows that stimu- 
lants can do no good ; and this quadrates with our experience 
with similar remedies in the collapsed stages in Asiatic cholera 
and congestive fever. If a remedy could be applied which 
would re-establish such a condition of the general system as 
existed before the delivery, we might reasonably expect re- 
lief. But what shall that remedy be ?* — Nashville Jour. 

A Case of Monomania. By John Travis, M. D., of Benton 
County, Tennessee. — On searching my note-book for 1840, I 
find a case of monomania which I cured by the most simple 
means. 

H. L., aged thirty-five, a married man with a wife and five 
children, had labored under partial insanity four years, the 
largest part of the time he confined himself to his bed. His 
appetite was good, and he generally ate as much strong food 
as a laboring man. He had been under medical treatment 
for more than three years, without relief. Finally his medi- 
cal adviser told him that he was not sick, and that he should 
go to work. This gave great offence, and he removed from 
the vicinity of his physician. He called on me to cure him. 
He related his diseases minutely — he said he had the gonor- 
rhoea, the piles, rheumatism, brain fever, liver disease, con- 
sumption, &c. According to Dr. Rush's instructions, I agreed 
with him, that he was diseased from the crown of his head to 
the soles of his feet. I made a box of one hundred pills of 
flour and white magnesia, and directed him to take one, morn- 
ing, noon, and evening — to ride a trotting horse ten miles 
every day, and work some in the garden daily. He thought 
it impossible for him to ride ten miles a day or work in the 
garden. I told him he would certainly die if he failed to at- 
tend to my prescription. In three months he visited me and 
declared himself well, and he has made a crop on his farm 
every year since. He said the pills were the best medicine 
he had ever taken. In this case, according to King Solomon, 
I treated a fool according to his folly. 

I have had many other cases of mental disease to treat, in- 
cluding mania, mania-a-potu, &c. In those I used active me- 
dicinal agents. 

This case is reported on account of the simplicity of its 
treatment. The exercise alone cured the patient. — Transyl- 
vania Med. Journ. 

* Would not compression of the Abdominal Aorta, as recommended 
on p. 320 of this number, have had a favorable effect. — [En. 



ECLECTIC AND SUMMARY DEPARTMENT. 337 

Professor Metiauers Aperient Solution. — Prof. Mettauer, 
in an article on constipation, speaks in the highest terms of 
praise of the following "Aperient Solution:" R. Aloes Soc. 
5iiss; Soche Supercarb. £vj ; Aqua Oiv ; Sp. Lavand. Co. 
f^ij. After digesting for fourteen days, the clear liquor may 
be decanted, or allowed to remain. Age improves both the 
power and taste of the solution. 

"I claim for myself," the professor says, "the sole credit 
of originality in the invention of this compound." * * * 
The aperient acts both on the liver and the muciparous glands ; 
corrects and prevents acidity ; and probably aids assimilation 
when oily articles are used for food. It should be given about 
half an hour after dinner and supper, the common dose being 
f5j, though in some cases this may be increased even to fsj. 
A single dose is sometimes sufficient, and then should be given 
at bedtime, diluting the solution with water, if desired. It is 
suitable to almost every example of constipation complicated 
with defective biliary secretion, except when the state of the 
stomach is alkalescent ; and may be used also in the constipa- 
tion of pregnancy." — Am. Journ. of Med. Sciences. 

On the Treatment of Erysipelas by the Muriated Tincture 
of Iron. By G. H. Bell, Surgeon. — We find, in the Boston 
Medical and Surgical Journal, an article by Mr. Bell, in which 
he recommends a mode of treating erysipelas, differing from 
that usually resorted to, but which he has found invariably 
successful. We have only room to quote one or two para- 
graphs, and must omit the cases which seem to warrant Mr. 
B.'s conclusions. He says : — 

" My purpose being purely practical, it would be out of 
place to premise with a disquisition on the nature and causes 
of inflammation ; but in order to explain in some measure the 
principle by which I have been actuated in employing a pow- 
erful tonic in a disease generally occasioning so much fever 
and cerebral excitement as erysipelas, I consider it necessary 
to repeat the opinion I have elsewhere expressed — viz., that 
* in inflammation, the capillary vessels having apparently lost 
the power of separating or electing the component parts of 
the blood which are necessary for functional purposes, and be- 
come to a certain extent inert tubes, a stream of blood is ad- 
mitted, for the circulation of which they are not calculated.' 
In other words, I consider that in erysipelas the capillary ves- 
sels are in an atonic state. 

" This hypothesis appears to me to be supported by the 



338 ECLECTIC AND SUMMARY DEPARTMENT. 

effect of the treatment I have adopted in erysipelas — the cases 
demonstrating that when an extensive portion of the surface 
of the body is violently inflamed, producing a high degree of 
fever and cerebral excitement ; on the system being rapidly 
surcharged "with, or brought under the influence of, the muri- 
ated tincture of iron, while the cerebral affection and other 
symptoms of fever subside, the local pain is relieved, and the 
redness and swelling gradually disappear ; and, so far as the 
tonic medicine appears to be concerned, all this is effected 
without any appreciable evacuation from the emunctories of 
the system. 

" Mode of administering the Remedy. — Of course the first 
object is to have the bowels freely acted on. If the erysipelas 
be mild, fifteen drops of the muriated tincture of iron are ad- 
ministered in water every two hours until the disease is com- 
pletely removed. When the attack threatens to be more 
severe, the dose of the tincture is increased to twenty-five drops 
every two hours, and persevered in night and day, however 
high the fever and delirium. The only local applications I 
ever find necessary are hair powder and cotton wadding. 
While I depend for the removal of the disease on the chaly- 
beate, it is necessary that the bowels should be attended to 
throughout the treatment. — Edinburgh Monthly Journal of 
Medical Science. 

Application of Collodion as a Preventive of Pitting in 
Variola, and its Use in cases of Mammary Inflammation. 
— Dr. Storer remarked that he had used collodion in one 
case, within a short period, successfully. The patient was 
very ill with small-pox ; upon the appearance of the pustules, 
those upon the face were brushed over, two or three times 
daily, with the above liquid until the period of desquamation. 
The patient, upon recovery, exhibited no pits upon her face. 

Dr. S. observed that Professor Evans, of the Rush Medical 
College, had reported several cases during the past year in 
one of the Western Journals, in which he used collodion ad- 
vantageously in mammary inflammation; suppuration was 
prevented in most of the cases, and relief obtained in all. 
His object in applying this remedy was to obtain a contrac- 
tion of the parts, supposing that thus the freedom with which 
the blood is forced into the mamma would be overcome, and 
the lymph absorbed by compression. 

Dr. S. had tried Prof. E.'s plan in three cases, but had not 
observed any decided effect from the application ; he is un- 



ECLECTIC AND SUMMARY DEPARTMENT. 339 

willing, however, to venture an opinion upon its value without 
further experience. 

Dr. Bowditch testified to the efficacy of collodion in the 
prevention of pitting from variola. 

Dr. Abbot supposed it to act bj its constrictive property, 
compressing the blood-vessels around the pustules, and thus 
diminishing the formation of pus. With this view he had 
applied it, in his own person, in threatened paronychia with 
success, the inflammation being completely arrested. 

Dr. Bowditch, referring to the apparent effect of pressure 
in preventing inflammation, mentioned a case of peritonitis, 
where the pressure made by the intestines upon each other 
seemed to arrest the diseased action, no inflammatory blush 
being observed between the intestinal convolutions. 

In another case, where the liver had pressed upon the 
stomach, the portion of the latter viscus thus situated was 
quite white and entirely uninflamed, while the rest was much 
affected. 

Dr. Jackson said he had often noticed similar facts, but 
had never previously thus accounted for them. He thought 
the effect of compression evident. — Morland; Extracts from 
Records of Boston Soc. for Medical Improvement. — [Am. 
Jour, of Med. Sciences. 

Fractured Vertebrae. Dr. S. D. Townsend showed the 
specimens. — The fourth dorsal vertebra fractured through 
its body, and also the spinous processes of the three next 
below it. The patient from whom these were taken received 
a blow from a "derrick," which first struck the head, then 
the bach. He was instantly paralyzed from the diaphragm 
downwards. He lived seventeen days ; a slough formed over 
the sacrum about the tenth day. — Ibid. 

Intra- Capsular Fracture of the Cervix Femoris. Death 
from Intestinal Strangulation. Dr. J. M. Warren related 
the case. — A gentleman, 83 years of age, fell upon a carpeted 
floor, striking the right trochanter. He was taken up suffer- 
ing severe pain. Foot everted and shortened half an inch. 
He was placed on the triple inclined plane, the foot supported 
by means of pillows and protected by a cradle. At the end 
of seven weeks he was able to move the leg without pain, and 
the foot was not disposed to evert. On the 30th of January 
he was seized with a pain in the epigastrium, accompanied 
by vomiting. Pain relieved on 31st, but the vomiting continued 



840 ECLECTIC AND SUMMARY DEPARTMENT. 

at intervals until his death, which occurred on the 4th of 
February. During this period there was no pain on pressure 
over any part of the abdomen, and no tumor perceived. One 
evacuation, of a solid consistence, took place from the bowels, 
hj means of enema, on the 2d of February. The urine was 
suppressed for 24 hours ; afterwards it was passed naturally. 
On examination after death, it was discovered that about 
eighteen inches of the ileum, in the neighborhood of the 
ccecum, had passed through an aperture in the circumference 
of the omentum, apparently made by an old adhesion ; all this 
portion of the intestine was black, but not in a state of gan- 
grene, the strangulation being partial. The capsule of the 
hip joint being opened, there issued a small quantity of dark- 
colored blood. A fracture was at once seen passing trans- 
versely through the neck of the bone ; the parts, however, 
were firmly interlocked, and it was only after efforts of forcible 
rotation were made that they partially separated. A portion 
of the periosteum, at the back part of the cervix, remained 
entire. The effects of the fracture were to produce a slight 
shortening of the neck of the bone, by the fragments being 
driven, as it were, one into the other, and an additional short- 
ness of the limb, from the partial drawing up of the shaft of 
the bone, by muscular contraction. — Ibid. 

Testicle retained in the Grroin ; Extirpation. Dr. J. M. 
"Warren showed the specimen. — The patient was 38 years 
old, and a small tumor had always been observed high up in 
the groin, which, from the absence of the testicle in the 
scrotum, was supposed to be that organ arrested in its de- 
scent. A year since, the tumor suddenly slipped farther 
down in the course of the inguinal canal, enlarged, and 
became painful, the pain extending into the abdomen, when 
the tumor was handled. On removal, the testicle was found 
in a disorganized state, enveloped in the tunica vaginalis, 
which was partially adherent to it. — Ibid. 



THE 

NEW JERSEY MEDICAL REPORTER. 

VOL. IV. NINTH MONTH (SEPT.), 1851. No. 8. 

Medical Reform, No, 2. By James H. Stuart, M. D. 

In my last I endeavored to depict the necessity for a medi- 
cal reform ; in my present, I purpose modestly to suggest 
the means. Legislative interference is, as before stated, for 
obvious reasons, manifestly out of the question. But we yet 
have left to us an unfailing resort. The great American 
Medical Association is, or ought to be in the medical world, 
a legislative body from whose decision there can be no appeal. 
It is composed of delegates, chosen for their competency, 
from all sections of the Union, and, of course, perfectly con- 
versant with the wants and interests of their own peculiar 
districts. Recommendations from it have heretofore had 
almost the weight of law. Witness the six months' lecture 
term, which was immediately adopted by that noble old in- 
stitution, the University of Pennsylvania, and has been since 
gradually coming into vogue among the other respectable 
schools of our country. In fact, as anything emanating from 
that body is but an expression of the will of the educated 
practitioners throughout the Union, it is impossible to with- 
stand it. Now let the delegates to this great power, once 
fully understand the necessity of reform, thorough, and im- 
mediate, and what will be the result ? The work will com- 
mence, and never cease until ignorance and charlatanry are 
banished from the regular profession. Let but an edict be 
passed to the effect that diplomas from ordinary medical 
colleges are not sufficient guarantees of professional ability, 
and we will soon see a different state of things. Let an 
vol. iv. — 27 



342 BUTLER ON THE ADULTERATION OF DRUGS. 

examining committee be appointed from among the best men 
in our country, connected or not, as the case may be, with 
schools, whose duty it shall be to examine thoroughly all 
candidates for the profession. And let these examinations 
have reference to general education, intelligence, and scientific 
knowledge, as well as the mere practical details of anatomy, 
practice, &c, &c. Their qualifications as gentlemen should 
likewise be considered. Once a year would be sufficient for 
the examinations, which might be held in the presence of any 
stated number of non-professional witnesses. Let these, and 
these alone, be an index of ability, and let the profession 
frown sternly upon all who pretend to practice without hav- 
ing passed the ordeal, and we would then have only the proper 
number of educated men practising, instead of the confused 
mass of educated, and ignorant blackguards and polished men 
which now crowd our ranks. There would then be no rivalry, 
such as now exists among the schools, to induce the turning 
out of hundreds of ignoramuses every year to devastate the 
country with their murderous tide ; but every man would feel 
that he had earned his position, and was interested in main- 
taining its dignity. Unless some such plan is speedily 
adopted, woe be to the man who studies medicine. Starvation 
and disgrace are his inevitable lot. But we hope for better 
things. The profession is waking from its lethargy. The 
evil has become unendurable and must work out its own cure. 
Erie, Pa., Aug. 1851. 



On the Adulteration of Drugs.* By S. W. Butler, M. D. 

Man is supplied in nature and by art, with remedies for 
many of the diseases to which he is liable, and the importance 

* See an article on "Drug Grinding" in that excellent quarterly, 
" The American Journal of Pharmacy" by Charles V. Hagner, who has 
for the last thirty-nine years been engaged in the business of grinding 



BUTLER ON THE ADULTERATION OF DRUGS. 343 

of having, in the hour of sickness, articles of certain properties 
and known strength, is self evident. Yet what physician does 
not know that many times his efforts in combating disease are 
foiled ; not from any error in diagnosis, but, from the uncer- 
tain action of the remedies he is obliged to employ ? 

The sulphate of quinia he orders may contain an unsus- 
pected adulteration of sulphate of lime, gum, sugar, mannite, 
starch, &c. ; powdered rhubarb may be adulterated with, he 
knows not what, and the color restored bj turmeric ; the cream 
of tartar he recommends may contain an indefinite quantity 
of sand or clay, and alum ; in fact, there is scarcely a drug 
in the whole catalogue on which he can rely for uniformity of 
strength. In this paper we propose to glance at some of the 
causes of this adulteration of drugs. 

First, The cupidity of those who gather the articles, who 
often mix with them inert foreign ingredients ; of the exporters. 
In whose hands this is carried still further ; and, perhaps, of 
the importers and druggists, many of whom, it is feared, do 
not scruple to contribute their quota towards self-aggrandize- 
ment, at the expense of suffering humanity, by a further sophis- 
tication. The wretch who dares to adulterate or counterfeit 
our national coin is held up to public execration, and, if appre- 
hended, is dealt with with the utmost rigor that the law allows. 
But a man may amass a fortune and roll in wealth by means 
of gains gotten by adulterating and thus rendering impure, the 
fountain-head of that stream which, in the economy of provi- 
dence, has been sent for the healing of our maladies, and not 
a lisp shall be heard against his nefarious practices, while loud 
complaints are made about the "uncertainty of medicine.'* 
To such a sad extent has this system of adulteration been car- 
ried, that Congress, a few years since, through the indefati- 
gable exertions of Dr. Edwards, of Ohio, passed a law estab- 
lishing the office of Drug Inspector in the larger cities on our 

drugs in Philadelphia. Mr. Hagner writes like an honest man, and it 
is to be hoped that he will pursue the subject, and that his articles will 
exert a beneficial influence. 



344 BUTLER ON THE ADULTERATION OE DRUGS. 

seaboard. This has, however, only partially remedied the 
evil, as it does not interfere with the sophistication of drugs 
by our own importers and druggists. 

Second. A second cause for this adulteration of drugs, had 
its origin, perhaps, not so much in dishonesty of purpose as 
in error of judgment, though a very palpable error. There 
formerly existed more than at present, a conventional agree- 
ment between druggists and drug-grinders, by which the former 
allowed the latter a certain per centage for loss in powdering, 
usually, we believe, from four to six per cent. 

On this point we will quote from Mr. Hagner's article, re- 
ferred to in a note on a preceding page. He says: "It is 
perfect nonsense to expect a uniform loss in powdering any 
particular drug, with but few exceptions. * * * * We some- 
times receive vegetable substances, roots, barks, gums, &c. ? 
direct from the hold of a ship, or from damp cellars; at other 
times we receive the same articles from the garret of a store 9 
where they may have been for a year or more. It is ridicu- 
lous to expect the same loss in both cases. Most of the arti- 
cles we powder contain more or less water, which we are 
obliged to dry out, and if we did not dry them artificially 
when we reduced them to such minute particles as constitute 
a fine powder, the water would escape by evaporation ; this 
constitutes the loss in powdering drugs, at least the great 
amount of it. Some time back, I received a large quantity 
of bayberry bark, from a house in this city, who had bought 
it without sufficient examination, for it had been completely 
saturated with water, purposely I suppose, by some ' financier,' 
to increase the weight. When I opened it and saw the con- 
dition it was in, I called the attention of the owner to it, but 
he had unfortunately already paid for it. I dried it, and it 
lost over thirty-five per cent, in the drying alone. Now what 
a position would I have been in had I been restricted to a loss 
of two or three per cent. ! It would have taken a considerable 
quantity of what Mr. Redwood* facetiously calls ' veritable 
powder of post' (saw-dust), to have made this matter straight- 

* American Journal of Pharmacy, vol. xxi., No. 1., January, 1849. 



BUTLER ON THE ADULTERATION OF DRUGS. 345 

" The important article of opium comes to us in very dif- 
ferent conditions. I believe it is the general custom of the 
druggists to keep this article in their cellars, to prevent its 
drying and losing weight ; some, however, do not, particularly 
when it is intended to be powdered ; of course the loss in the 
former must necessarily be greater than in the latter instance, 
and it would be perfectly unreasonable, under such circum- 
stances, to bind the powderer to a regular per centage of loss 
in powdering opium. I have been informed, and I believe cor- 
rectly, that there exists in some other places a conventional 
rule of six per cent, in powdering opium ; so far as I re- 
member, I rarely, if ever, powder it at a less loss than eight 
per cent., and sometimes as great as twenty per cent." Mr. 
Hagner says : " I have met with instances (not many to be sure, 
and none lately), where persons have sent their opium else- 
where to be powdered, for no other reasons than that of the 
loss being less than I made. Perhaps I might have satis- 
fied them had I made use of the ■ powder of post,' or some- 
thing else, which is and must be done by every one who 
powders ordinary opium at a loss of only six per cent. This, 
however, I never have done, and never will do. I do not pro- 
fess more honesty than my neighbors ; but, if I had no scru- 
ples on the subject, I can imagine a case where I might make 
myself amenable to justice, as a participant in causing the 
death of a fellow being, whose life might be lost for the want 
of a proper article being administered. * * * Opium is one 
of the most important of the drugs that pass through my hands. 
Every physician, druggist, and apothecary, knows the import- 
ance of having it right, and, so far as it depends on me, it 
shall be right, be the loss in powdering what it may. 

" With a conventional loss of six per cent., there can be 
no uniformity in the article. A powderer receives a lot of 
opium so dry that it only loses six per cent, in powdering. 
He receives another lot that loses twenty per cent. To bring 
the loss on the latter to the same as the former, he must put 
in fourteen per cent, of adulteration, and then you have one 
article fourteen per cent, less in efficiency than the other." 



346 BUTLER ON THE ADULTERATION OF DRUGS. 

Here, of course, we have a very evident cause of the uncer- 
tain action of medicines. The above extract from Mr. 
Hagner's article shows the dilemma in which drug-grinders 
are placed where this conventional rule is observed, and he 
says : " There is, perhaps, no other business in which there 
are greater opportunities, more temptations to dishonesty and 
fraud, and more thanklessness — I may say punishment — for 
being honest, than in this business of powdering drugs." 

Third, Another cause of the adulteration of drugs, and, 
perhaps, a principal cause, rests with the consumer himself. 
People measure the price of their medicines by the prices of 
their cloths, articles of provision, and other commodities, 
forgetting that, while the former is frequently the product of 
nature, often limited in its production to a very small portion 
of the earth's surface, from which the whole market of the 
world must be supplied, the latter is the product of the industry 
of man, and can be afforded for a price in proportion as the mar- 
ket is stocked with the commodity. A person having occasion 
to use a medicine, goes to an apothecary for it, but complains 
of the price. Perhaps a less honest neighboring apothecary, 
pandering to the public taste for cheapness, can produce the 
same article in name for half the price. The discerning 
public, tickled at the idea of getting medicines " so cheap," 
patronize the man who shamelessly hesitates not to risk the 
life and wellbeing of his customers that he may fill his coffers 
with gold. 

Thus have men, who else had been too honest, been forced 
to yield to the general demand for cheap drugs, even at the 
expense of their purity. 

We might, perhaps, enumerate as a fourth cause of this 
adulteration, the lamentable ignorance of too many physicians 
of the properties of drugs. Those who feel disposed to 
adulterate drugs, too often know that as far as the physician 
is concerned, they can do it with impunity, as there will be 
little fear of detection. This should not be so ; our physicians 
should be good pharmaceutists. It would be well if students 
of medicine were all required to learn the business of an 



PARRISH ON DYSENTERY. 347 

apothecary. But if they have not done this, they ought, at 
least, to attend schools of practical pharmacy, where they 
may learn all that it is essential for them to know with regard 
to the sensible properties and qualities of drugs, and thereby 
make themselves better judges of the medicines they pur- 
chase. 

We think, though, that on all the above points there is of 
late a change for the better. Vast quantities of spurious, 
impure, and damaged drugs are annually rejected at our 
custom-houses ; the conventional rule for allowing a certain 
per centage for waste in powdering drugs is not now generally 
observed ; people are becoming more disposed to patronize 
those apothecaries who will furnish them with good pure 
drugs, be the price what it may; and colleges of pharmacy 
and schools of practical pharmacy are exerting a beneficial 
influence. 

There is another matter on which we had intended to make 
a few remarks, and may make it the subject of another paper. 
We refer to the degree of fineness of powders, and the inti- 
macy with which compounded medicines are mixed. 

Burlington, N. J., Aug. 1851. 



An Inquiry into the Pathology of Dysentery, with remarks on 
its treatment. By the Editor. 

It is the duty of a physician in the midst of a threatening 
epidemic, surrounded by anxious parents and friends, who look 
to him for counsel and aid, in the hour of affliction and danger, 
to avail himself of every remedy which his own experience, or 
the experience of others, has proved to be useful in staying 
the hand of disease and death ; while it is equally his duty to 
judge wisely, and decide for himself, according to the symp- 
toms which he is required to treat. To practice medicine 
after the dictum of any author, or to follow the routine of 



348 PARKISH ON DYSENTERY. 

remedies prescribed in books for certain diseases, merely be- 
cause they are recommended, and without regard to the patho- 
logical condition presented in each individual case, would be to 
expose the sick to greater danger from the interference of the 
prescriber, than to allow the powers of nature to struggle alone 
with the disease. We make this remark because we believe 
physicians are too apt to rely upon the authority of great 
names, and too little disposed to think, judge, and act for 
themselves. And while we know that it requires care to avoid 
presumption on the one hand, and blind subservience to rules 
on the other, we are well persuaded that a close study of 
pathological science will lead to the development of mature 
truth in medicine. Under this conviction, we have endeavored 
to observe with care, the treatment prescribed by most authors 
for the cure of dysentery, and to practice in a manner which 
seems to us most in accordance with sound judgment and 
science. 

Dysentery is said to be an inflammation of the large intes- 
tines, the mucous coat of the descending colon, and rectum 
being principally involved ; and, as in most forms of inflamma- 
tion, the lancet is presented by authors generally as a valuable 
means of arresting the disease in its onset. To bleed freely 
from the arm, or to abstract blood largely from the abdomen 
by means of cups, or leeches, is advised as a preliminary step 
of the utmost importance. Now we propose to show, without 
attempting, or wishing to undervalue the writings of eminent 
medical men, or the opinions of those who are not authors, that 
the practice of depletion, at least so far as relates to the treat- 
ment of epidemic dysentery in malarious districts, is not de- 
manded by the condition of the system. In the first place, 
we are disposed to question the existence of acute inflammation 
in its incipient stage. We think the griping pains, distressing 
tenesmus, and other peculiarities of the disorder may be ac- 
counted for on other grounds. Take a patient, even of a full 
habit of body, who, by exposure to a variable temperature, 
privation from good and sufficient diet, or inhalation of mala- 
rious vapor, is brought to his bed with excessive heat in the 



PARRISH ON DYSENTERY. 349 

rectum, pain along the course of the colon, and other ordi- 
nary symptoms of dysentery. Must we conclude that the pain 
results from inflammatory action? May not a congestion of 
the hemorrhoidal vessels occupying the surface of the rectum, 
so fill up the passage as to create the heat and straining of 
which the patient complains ? And failing to be relieved, may 
not the irritation be transmitted along the course of the tube, 
giving rise to tenderness of the whole abdomen? A supposi- 
tory placed in the rectum produces a strong desire and effort to 
evacuate the bowels. Suppose the canal to be already emptied, 
and the suppository retained, would not the presence of such a 
substance cause pains in the upper bowels, and even sickness 
of stomach, if not removed ? Why then may not a congested 
state of the vessels, which supply the rectum, act as a foreign 
body producing local irritation, and by its continuance trans- 
mit the same sensation to other parts of the abdominal viscera ? 
And why may not the circulatory and nervous systems so sym- 
pathize with this engorged state of the vessels of the rectum, 
as to cause an irritable pulse and febrile surface? — for it is 
generally admitted that if fever is the first symptom noticed, 
without pain or dysenteric discharges, the dysentery is mere- 
ly an attendant upon, or a complication of, some other form 
of disease. These inquiries have arisen in our own mind, 
as we have observed the course of the disease, both in its 
sporadic and epidemic form, for a few years past. And we 
have, invariably, treated such cases of it as have come 
under our care, without the use of depletory measures. Be- 
low, we offer a brief history of an epidemic dysentery which 
occurred in this city during the months of July and August 
of last year (1850). The disease appeared coincident with an 
overflow of the meadows, in the vicinity of the town, occasioned 
by a breach in the banks which protect them from the river. 
In consequence of the extent and continuance of the freshet, 
the land in the immediate neighborhood, remained under water 
for seven or eight days; and, after its subsidence, a succession 
of very hot days occurring, the exhalations arising from de- 
cayed and decaying animal and vegetable matter were ex- 



350 



PARRISH ON DYSENTERY. 



tremely offensive, and no doubt contributed to aggravate the 
disease, which already prevailed to a considerable extent. The 
varieties of age, sex, per centage of mortality, &c, may be 
seen by the following table : — 





Number of Cases. 


No. 


of Deaths. 




Males. 


Females. 


Males 


Females 


Under 2 years age, 


. . 8 . 


IT 
i . . 


. . 2 


. . 4 


Between 2 and 10 . . 


. . 16 . . 


9 . . . 


. 3 




" 10 " 20 . 


. . . 7 . 


8 . . 


. 1 




" 20 "30 . . 


. . 6 . . 


18 . . 


n 




" 30 " 40 . 


. . , 10 . 


. 16 . . 


<< 




Above 50 


. . 1 . 


4 . . 


«< 






48 


62 

48 


6 


4 
6 



Total 110 Total 10 

These statistics are taken from our memorandum book, and 
comprehend only the cases which came under our own care. 
The deaths occurred invariably with children ; most of them 
were teething, or were suffering from some complication pecu- 
liar to childhood. The oldest was a boy of twelve years of 
age, but recently removed from the almshouse, and was of a 
scorbutic habit of constitution. In those cases which presented 
none of the complications referred to, opium was employed 
as the principal remedy; and we are well satisfied that this 
drug possesses the power to control and cure dysentery in 
most instances. Given largely, it will cut short the disease in 
its incipient stage in a very short time. Our own practice 
has been, to administer to an adult, two and even three grains 
in cases of extreme suffering at a single dose ; to insist upon 
perfect rest in the recumbent posture, to elevate the hips by 
pillows, with a view of diverting the current of the circulation 
from the rectum, to allow but little nourishment except that 
of the blandest kind, as gum water, linseed gruel, &c, and 
we have generally been satisfied with its effects. Of course, 
if there is reason to believe that hardened faeces, or crude 
ingesta, are lodged in the bowels, they are removed by ap- 
propriate cathartics ; but we believe the great and prominent 
indication in this disease is to keep the bowels at rest after 



PAERISH ON DYSENTERY. 351 

they are emptied ; and then, by position, to prevent the ex- 
cessive flow of blood to the seat of pain, while opium is 
administered to relieve spasm and tenesmus, control the cir- 
culation, strengthen the nervous system, and produce sleep, 
all of which indications it is capable of fulfilling. 

We have sometimes combined other remedies with opium ; 
but the fact that no other medicine, when employed alone, 
will relieve the distressing symptoms — that to make it effect- 
ual it must be united with opium in some of its forms — is 
sufficient to induce the inquiry whether after all, opium may 
not be relied on, itself. But. are not the secretions vitiated ? 
Must we not use an alterative ? Let us decide, then, which 
of the secretions is deranged, and what is the cause and 
nature of its change ; for if we are to use an alterative, we 
must know what requires to be altered. Experience has 
taught us that the bladder, urethra, stomach, and liver, 
sometimes sympathize so freely with the diseased intestine as 
to give rise to various complications depending upon the seat 
of functional derangement; so much so, that the biliary, gas- 
tric, and renal secretions become modified in their appearance 
and properties, and seem to call for special treatment ; but 
if they are the results of the pathological condition which 
marks the disease, and dependent merely for their existence 
upon the sympathetic relations which are sustained between 
the different organs of the body, is it not more in accord- 
ance with sound principles of science to relieve the secondary 
symptoms, by removing the primary cause from which they 
originate ? If, then, the function of the liver, for example, 
is so disturbed by the intestinal disease as to create either a 
diminution or increase in the quantity of bile secreted, or if 
this fluid should, from the same cause, become changed in its 
character, why give calomel or any other medicine simply 
with a view of altering the properties of the particular secre- 
tion, when the same result would flow, as a matter of course, 
from the removal of irritation, and relief of pain, heat, and 
tenesmus in the bowel ? By the same rule we should give 
diuretics to stimulate the kidneys and bladder, when from sym- 



352 PATTERSON ON SANTONINE. 

pathy, they fail to perform their functions. We do not urge 
any objection to the rule, except the fact that these com- 
binations are apt to increase the irritation of the colon and 
rectum, even when guarded by opium, if continued for any 
considerable length of time. When the skin is hot and dry, 
we have found in our experience, the most grateful remedy to 
the patient, and we believe, one equally successful with most 
internal remedies, to be sponging the surface of the body with 
cold water and alcohol, whisky, or some convenient alcoholic 
liquor, to be followed by friction with a dry, coarse towel. In 
the adynamic form of the disease, or in the latter stage of 
ordinary cases where stimulation is demanded, we have seen 
the most signal benefit follow the administration of the follow- 
ing mixture : — 

R. Aqua Cam ph. f^iv. 
Pv. Gr. Acac. 3ij. 
Chloroform gtt. lx. 
Tinct. Opii. f^iss. 
M. Signa. A tablespoonful every hour till relieved. 

Under the use of this remedy we have seen in protracted 
cases of the disease warmth return to the surface, and vigor 
to the pulse, in a few hours, when there seemed but little hope 
of permanent reaction. We cannot, therefore, fail to believe 
that the opiate and stimulating plan of treatment is that 
which is most likely to be successful in the treatment of the 
epidemic form of dysentery, particularly in malarious districts. 



Santonine. By George W. Patterson, M. D., Resident 
Physician of the Northern Dispensary of Philadelphia. 

Having recently made free use of santonine for the expul- 
sion of the ascaris lumbricoides, I desire to express the 
satisfaction which I have had from its employment, being in 



PATTERSON ON SANTONINE. 353 

a concentrated form, and possessing neither taste nor odor, 
qualities which, at least, should be sufficient to give it some 
claims to consideration. 

As an anthelmintic, it has a special mortal action upon 
lumbricoid worms. This I infer to be the case, from the fact 
that, while it has failed in my hands when used against tsenia 
and the ascaris vermicular is, it has rarely done so when 
there has been sufficient evidence of the existence of the 
common round worm to warrant its use. 

Whether the presence of such parasites in the alimentary 
canal is deserving of the notice or regard of physicians, which 
some seem to deny, it is not my purpose at present to con- 
sider ; but as there are those who do believe them to be a 
source of annoyance, and especially to children, I would re- 
commend a trial of this vermifuge. It is a medicine that at 
one time had a considerable degree of celebrity ; but, from 
some unknown cause, it is at the present time but little em- 
ployed. It is somewhat expensive, and the article which I 
used was presented to our institution by Messrs. Powers and 
Weightman, chemists of this city. 

I am in the habit of prescribing it in the following manner, 
say to a child four years of age : R. Santonine gr. xii ; Pulv. 
Gr. Acacias gr. vi ; M. et in chart, iij div. One to be given 
night and morning, and followed by a dose of fluid ext. of 
senna. I have been informed, in some instances, that worms 
were expelled before the cathartic was given, still I consider 
its administration desirable, serving to discharge that super- 
abundant mucus which is usually an attendant upon such 
cases. The subsequent administration of the syrup of the 
citrate of iron, I have usually found, will correct that state of 
the system which is so favorable to their production and 
multiplication. 

Those who may use this medicine for the first time, will 
probably have their attention directed to the color of the 
patient's urine, the santonine having caused it to assume a 
saffron hue. This is not the result of irritation, which I have 
never known it to produce. 



354 EDITORIAL. 

While in the choice of remedies, it should be our object to 
select such as are the best suited to meet the indications pre- 
sented to our notice, we should never lose sight of the fact 
that medicines are, for the most part, repulsive to persons in 
a state of health, and become even more so when suffering 
from morbid derangements ; that it is our absolute duty to 
administer them in as palatable a form as possible, and always 
to prefer such as are insipid or inodorous when no benefit can 
be obtained by a different course. I have had frequent occa- 
sion to witness the embarrassment which practitioners have 
experienced from want of attention to this matter. Enter- 
taining such views, I have been prompted to make use of 
santonine as an anthelmintic, with which, after a fair trial, 
I have every reason to be pleased. 

Philadelphia, August 'list, 1851. 



EDITORIAL. 



Death of Job Haines, M. D. 
Another has fallen. Within the last three years, four 
physicians of this county have been called to their final account. 
All of them, save one, were in the prime of life, with buoyant 
hopes of success in our honorable profession ; but none more 
so, than the subject of this notice. Dr. Haines was a man 
possessed of amiable qualities of mind, and, being gifted with 
a pleasing address, was rapidly finding his way to a promi- 
nent position in the community where he lived, and pursued 
with industry the practice of medicine. He was a graduate 
of the Jefferson Medical College, and, soon after his settle- 
ment in our State, connected himself with the District Medical 
Society of Burlington County, of which he was the Recording 
Secretary at the time of his death. But about twenty-eight 
years had rolled over his head, most of which he had enjoyed 



EDITORIAL. 355 

in the peaceful retirement of rural life ; and, just as circum- 
stances were promising him an easy road to celebrity, and he 
found himself comfortably located in a community where he 
was respected and appreciated as a citizen, friend, and phy- 
sician, and in a domestic circle where he was honored and 
loved as a husband, and father, the unseen messenger came 
and carried him to another home. He died of inflammation 
of the brain, after an illness of about eight days. The aged 
and infirm, whose talents and strength have been spent in 
doing good to their fellow-men, and in the promotion of 
sound truth in our science, leave their works here, for a final 
reward hereafter, and there is a sense of sorrow thrills the 
heart as their gray hairs are covered forever from our sight ; 
and yet the knowledge of the fact that in the regular order 
of nature's laws they must yield, reconciles us to their loss ; 
but when the young, sprightly with hope, in the midst of 
health and anticipated prosperity, laboring to be useful, honor- 
able, and good, are suddenly smitten by the hand of disease 
and death, it is difficult to realize that their places are really 
vacant among us, till time writes it out in the sad experience 
of every day, and we learn to believe, by their continual 
absence, that they will return no more. We regret that we 
cannot lay before our readers a more detailed account of the 
life and death of our departed friend; but we could not, 
in justice to our own feelings, allow the opportunity to pass, 
of leaving upon record this humble tribute of respect to his 
memory. 

Death of Jesse Delano, M. D. 

We insert below all that we know of the death of another 
member of the profession of Essex Co. : — 

" At a special meeting of the Essex District Medical So- 
ciety, held last evening, in the absence of the President, Dr. 
L. A. Smith was called to the chair. Intelligence having 
been communicated of the death of Dr. Jesse Delano, the 
following resolutions were reported and adopted : — 

" Hesohed, That we have received the intelligence of the 



356 EDITORIAL. 

decease of Dr. Jesse Delano with unfeigned regret. That 
we remember him as a respectable member of our society, who 
reflected honor upon the profession, and contributed to its 
reputation and usefulness. 

" Resolved, That we communicate to the family of the de- 
ceased our sympathies for them in this hour of their affliction, 
and that we will wear the usual badge of mourning for thirty 
days. 

L. A. SMITH, Chairman. 

Wm. T. Mercer, Secretary. 

Newark Daily Advertiser, Aug. 14th. 

Newark Daily Advertiser vs. Quackery. 

The following paragraph is taken from the Newark Daily's 
list of notices of periodicals, magazines, &c. : — 

" Throat Ail, Bronchitis, Consumption; their Causes, /Symp- 
toms, and Cure. By Dr. W. W. Hall, N. Y., Redfield. 
Newark : Rogers & Agens, booksellers. 
" This work is written as an advertisement for the author. 
It contains nothing new, and the principal paragraph but 
states the direction to the author's residence, and his terms. 
True merit needs no such means to be made generally known, 
and we have no intention of aiding persons of whose merits 
we are ignorant, who resort to such unprofessional means 
for notoriety, and who make a trade of a lofty art." 

What other public newspaper of New Jersey will do the 
same, with works of like character when sent to them 
for notice ? If all our editors would refuse to give coun- 
tenance and credit to the volumes of trash which are laid 
upon their tables, they would throw, at least, as much of 
their influence in favor of the common good, as they now do 
against it, by the aid which they give to ignorant men who 
promise what they never can accomplish, and with whom the 
principal object is to promote self-aggrandizement, by prac- 
tising imposition upon the ignorant and credulous. 



ECLECTIC AND SUMMARY DEPARTMENT. 



A Case of Chorea reported and read before the Belmont Medical Society. 
By Henry West, M. D. April 4th, 1850. — Miss L. S., aged fourteen, 
of delicate constitution, had enjoyed generally good health, was attacked, 
on the 27th of February last, with " slight headache and sore throat," 
which did not attract much attention from the family until the 2d of 
March, when she presented some unusual symptoms, which were not 
understood by them. A physician was called on, who visited and pre- 
scribed but once, when other business called him from home. The 
patient remained, as I was informed, in about the same condition until 
my first visit, which was on the 13th of March, when she presented the 
following symptoms, viz : Irregular and involuntary contraction of the 
muscles of almost the whole voluntary muscular system, more so, how- 
ever, on the right side ; inability to protrude the tongue ; rolling the 
eyes ; by placing any substance in the palm of the hand and requesting 
her to grasp it, the fingers would immediately become strongly extended ; 
inability to articulate ; no loss of consciousness ; appeared perfectly 
sensible and knew what was said to her ; slept reasonably well, during 
which she was entirely calm ; had no fever ; pulse eighty-five, small and 
of moderate resistance ; bowels rather constipated ; discharges natural 
color ; urine scant and high colored ; had never menstruated ; slight 
tenderness in the right iliac region ; also slight tenderness over third, 
fourth, and fifth dorsal vertebrae ; no headache or pain in any part of 
the body ; was unable to walk or sit in a chair ; tongue coated with a 
light yellow fur, with a few clean spots over its surface. 

Cause. — Various are the causes set forth by authors, all of which, in 
some cases, no doubt, may be correct. The remote cause in this case, 
in my opinion, was the approximation of menstruation ; the proximate 
cause the functional derangement of some portion of the brain, and, 
most probably, the cerebellum, as set forth by some recent writers on 
physiology. The doctrine is, " that one of the functions, the principal 
office, indeed, of the cerebellum, is to preside over and regulate the faculty 
of locomotion, to keep the muscles in due subordination, as it were, to the 
ioill." To this I am partly inclined to subscribe. To the cerebrum 
has been appropriated the organ and direction of the intellect, and pre- 
sides over all our intellectual functions. There are, as all are aware, 
certain altered states of that portion which lead to mental aberrations. 
Persons so affected from false judgments cannot associate the ideas 
aright, &c. Just so with the cerebellum when, from some exciting or 
debilitating cause, it loses its power and control over the parts over 
which it presides, and, for a time, permits its satellites to take their 
own course ; and a grotesque and unseemly out do they make of it, not 
unlike a regiment of soldiers when they lose their commanding officers, 
no order or regularity being observed. 

Treatment. — Two indications presented themselves to my mind ; first, 

to remove the constipated state of the bowels and loaded state of the 

tongue ; second, to obviate the debility of the nervous system, but more 

especially that portion of the encephalon from which the motor power 

VOL. IV. — 28 



358 ECLECTIC AND SUMMARY DEPARTMENT. 

originated, and, fearing my theory might not be altogether correct, I 
turned my attention somewhat to the spinal column. 

March 15th. — I made the following prescription : — 

Take Calomel 16 grains ; 

Ipecac 1 " 

Pulv. Antim. 8 " 

M. ft. pulv. No. 8. 

One to be given every four hours 7 to be followed by infusion of 
senna. 

For external application — - 

Take 01. Olivse 2 ounces; 

Aqua Amnion* 1 " 

01. Sassaf. 2 drachms. 

M. ft. liniment. 

To be rubbed freely along the entire spinal column. 

March \§th. — Medicine had operated pretty well ; not much improve- 
ment ; alvine discharges, somewhat dark ; tongue rather improved ; 
involuntary motions about the same ; continued the prescriptions as 
before, except to discontinue the ipecac, and add spirits of turpentine to 
the liniment. 

March 20th. — Medicine had again operated well ; tongue cleaned ; 
pulse eighty, weak ; extremities cold ; involuntary motions the same. 
Prescribed Precip. Carb. Iron 30 grains; 

Sulph. Quinine 4 " 

M. ft. pulv. No. 16. One to be taken every s*x hours f and the bowels 
to be kept open with infusion of senna. 

March 22d. — Somewhat improved ; pulse eighty-two^ with more 
strength ; extremities not so cold : involuntary motion not so great ; 
could articulate monosyllables; some appetite ; continued the prescrip- 
tion, except to increase the iron half a grain in each dose. 

March 24th. — Still improving ; can grasp objects presented to her ; 
sits in a chair ; speaks short sentences ; appetite improving. 

28^. — Much improved ; very little involuntary motion, some slight 
about the muscles of the face and eyes ; can stand alone and walk a few 
steps, but as yet very awkwardly ; iron increased half a grain ; con- 
tinued same medicine. 

31st. — The first salutation when I entered the room was, "Doctor, I 
am almost well/ 7 and rose to meet me, and extended her hand and gave 
mine a firm grasp. I advised her to continue the use of the precip. 
carb. fer.ri for some time to come. Her step is still weak, and unless 
the remote cause be entirely removed, I feared a re-attack. My inten- 
tion is to continue it until her health be entirely restored, and probably 
until menstruation shall be established. 

P. S. The treatment has been continued, and the patient is now in 
the enjoyment of good health. — Trans. Belmont Medical Society. 

Circular addressed to the medical profession of the United States : — 
" The undersigned, having been appointed, at the last meeting of the 
American Medical Association, Chairman of the Committee on the 
1 Results of Surgical Operations in Malignant Diseases/ respectfully 
solicits contributions to the subject, founded upon personal observation. 
To place the subject in as tangible a form as possible, he begs leave to 
direct attention to the following points : — 

" 1. The difference between cancerous and cancroid diseases, or those 
affections which are truly malignant, and those which are only partially; 



ECLECTIC AND SUMMARY DEPARTMENT. 359 

so. In the former category are comprised scirrhus, encephaloid, and 
melanosis ; in the latter, certain maladies of the skin and mucous tis- 
sues, as lupus, cheloid, eiloid, and cancer of the lip. 

'" 2. The precise seat of the disease, as the skin and subcutaneous 
cellular tissue ; the eye, ears, nose, face, lips, tongue, salivary glands, 
jaws, and gums; the lymphatic ganglions of the neck, axilla, groin, and 
other regions ; the mammary gland, uterus, ovary, vulva and vagina, 
penis and testis ; the anus and rectum ; and, finally, the extremities. 

" 3. The age, sex, temperament, residence, and occupation of the 
patient. 

"4. The cause of the disease, its progress, and the state of the part 
and of the system at the time of the operation. 

"5. Mode of operation, whether by the knife, caustic, or ligature. 

" 6. Time of death, or relapse, after operation. 

" 7. Examination of the morbid product ; how conducted, whether by 
the unassisted eye alone, or by means of the microscope and chemical 
tests. 

"The undersigned hopes that the importance of the subject confided 
to him, as chairman of the committee above referred to, will be suffi- 
ciently appreciated by his professional brethren to induce them to aid 
him in carrying out the wishes of the American Medical Association. 
The subject is one of absorbing interest, and cannot fail, if properly 
treated, to elicit matter of the greatest benefit. It is very necessary 
that all communications on the subject should be sent to the chairman 
of the committee by the first of January, 1852. 

" Medical journals and newspapers friendly to the interests of medi- 
cal science will confer a favor upon the undersigned by inserting the 
above notice, 

" S. D. GROSS, M. D. 

" University of Louisville, June29tk, 1851." 

Woman's Dress a Cause of Uterine Displacements, Read before the 
Boston Society for Medical Improvement, July 28th, 1851, by Dr. W. 
E. Coale.— The great and increased frequency of uterine displacements 
in the last few years, must have forced itself upon the attention of 
every practitioner of medicine. A peculiarity, too, that they have of 
late assumed is, that they are now met with in very young persons, 
whilst medical authors, writing not a quarter of a century ago, describe 
them, unless in exceptional cases, as affections to be found in women 
who have several times undergone the labors of a mother — in those of 
originally defective constitutions — in those who have been imprudent 
in making exertions too soon after childbirth — or, in short, in those who 
have been worn down and enfeebled by any cause calculated to lessen 
the general tone of the system : imprudence in habits of life — overtask- 
ing in particular occupations requiring a stooping position, decay from 
age, &c. We find, however, now — and I appeal to those present for a 
candid confirmation or contradiction of the assertion — that a large 
number of cases of prolapsus uteri occurs in those in early womanhood, 
and some in those who have scarcely advanced beyond girlhood. For 
my own part, without recurring to former cases, the fact that at this 
moment I have under my care five — not one older than twenty-three, 
one of them but eighteen years of age, not one of them a mother, none 
engaged in any exhausting occupation — gives me warrant for what I 
say, and, though accident may just now have greatly increased my 
proportion of such cases, I cannot believe that in the total my experi- 



360 ECLECTIC AND SUMMARY DEPARTMENT. 

ence is very different from that of others present. It is, then, surely 
an interesting subject for inquiry as to what are the causes of the fre- 
quency of these affections just now ; and why are the youngest, and, in 
other respects, the heartiest women the victims of it. 

One undoubted explanation for some of this frequency is, that from 
an increase of medical research and inquiry upon the subject, the dis- 
ease is now detected where formerly it was passed by unrecognized, so 
that the increase of frequency is not so great as at first might be 
imagined. I. state this in the outset plainly, that it may have its full 
force as far as it can go, and that it may not be supposed that I have at 
once gone to a favorite theory, not looking carefully and without pre- 
judice to other sources. 

Throwing out, then, a fair proportion of cases, as accounted for above, 
we still have left a large number for which we must seek other means 
of accounting. These, we believe, we find in the mode of dress now in 
fashion amongst our women — the peculiarity of which, as interesting to 
us is, that it is supported almost entirely from the waist — using that 
word, not in the dressmaker's sense, but in its old meaning as designat- 
ing the contracted portion of the figure just above the hips. 

Until the last fifteen years, although the dress was at times worn 
very low on the chest, it was always hung by broad shoulder-straps, 
frequently coming from the shoulders very high up towards the sides 
of the neck. A reference to any prints illustrating the fashions of this 
century prior to the time mentioned, or the costumes of England or 
France for any period, will more fully explain this if necessary. About 
fifteen years since, as a ball-dress, the shoulder-straps were left off, so 
that the upper line of the dress was perfectly horizontal, and this, with 
those elastic views of delicacy so peculiar to fashion, was often low 
enough to disclose the edge of the armpit. In this style there was ap- 
parently great danger of the dress slipping down, and it would do so 
but for the ingenious, though not graceful, contrivance of suspending 
it from uprights of whalebone, the lower ends of which are supported 
at the waist. This, from being a ball costume, has become more and 
more common; so that now, even when high-necked outer dresses are 
worn, the under dresses are cut low and supported as above described, 
in order to suit if a change be made in the former. Thus much for the 
part of the dress above the waist, to which we attribute its measure, 
though not a very large one, of the affections under consideration. 

To the part below the waist, however, we believe we can look with 
confidence for a full and satisfactory explanation of the mischief done. 

With a view of improving their shape, the lower part of the dress of 
women now consists of six, eight, or even more, skirts,* made of various 
materials; cotton — the stiff woollen material, intended for curtains, 
called moreen — flannel, and, at times, quilted with cotton wool, weighing 
together, as ascertained by actual experiment, ten, twelve, and even 
fifteen pounds. Each of these is supported by a string drawn very 
tightly around the body. We have seen the marks of these strings for 
days after the skirts have been removed — we have seen them even after 
death. Here, then, is the first source of evil — the continued pressure 
and constraint that these strings keep up — evidently embarrassing 
greatly the organs within. When to this, however, we add the weight 
of the skirts, we cannot but at once perceive how great an additional 

* This is on the confession of patients themselves, or I could not believe or 
dare state it. 



ECLECTIC AND SUMMARY DEPARTMENT. 361 

force we set to work, particularly if its operation — as exerted upon 
organs having amongst themselves a mobility almost as great as that of 
fluid — be properly estimated. To protect the abdominal viscera against 
this pressure, remember there is nothing, in front, at least, save a thin 
partition of woman's soft and tensionless muscle. That these viscera 
should be forced downwards is not surprising ; that they must, in turn, 
exert an equal force downward on the pelvic viscera, is apparent ; and 
that the uterus, the most moveable of the last, and the most obnoxious 
by its situation to receive such an impulse, should give way to the con- 
tinual assaults upon it, is what we might most readily expect from the 
premises. Here we have an explanation full, and, we trust, convincing, 
of the frequency of a disease in the youngest and heartiest of the sex, 
which, twenty years since, was considered peculiar to those whose 
powers of life were greatly exhausted by demands upon them, or were 
already on the decline from age, an explanation, I may mention in 
passing, not yet offered, as far as I can ascertain, by any other writer. 

We look upon the mischief thus done as no whit less than that effected 
by tight lacing ; bat, if anything, greater, for it is more silently done. 
Friends cannot see, and do not understand, the evil at work, and, 
therefore, can give no warning word. The symptoms themselves com- 
mence so gradually, and point so indirectly to the cause, as to excite no 
alarm in the victim. Exercise, which ought to invigorate, soon fatigues 
and becomes distasteful. Ascending a flight of stairs, or stooping to 
lift a comparatively lightweight, instantly loads the hips with a burden 
that can scarcely be borne. The back, particularly at the lower part, 
feels sprained, and memory is taxed in vain for some injury to account 
for it. Dragging sensations around the hips, pain down the legs, and 
weak knees, are attributed to rheumatism. The symptoms may now 
begin to point more directly to the real seat of the trouble — every 
monthly period brings renewed sufferings, from which the system rallies 
more and more slowly — daily and hourly embarrassments occur of 
nearly all the organs within the pelvis — an irritable bladder (a very 
frequent symptom in my experience) — haemorrhoids — unceasing pain 
and continual sensation of bearing down. The retiring delicacy of maid- 
enhood shrinks from telling these, and unless marriage happily brings 
her under the care of a physician, the mischief goes beyond the hope 
of relief. 

Displacement of the uterus, though the most permanent and grievous 
trouble produced by the heavy skirts, is not the sole one. Close ob- 
servation and more particular inquiries into the symptoms of dysmenor- 
rhea have convinced me that in very many cases the pressure above 
described keeps up, if it does not actually induce, a plethora of that 
organ, to which much of the sufferings at those periods may reasonably 
be attributed. This plethora, too, cannot be repeated often, or con- 
tinued for a great while, it is evident, without alterations in the uterus 
itself, which must tend still further to embarrass it in the performance 
of its functions, and entail suffering upon the patient. Acting upon 
my conviction of this cause of suffering at the monthly periods, I have 
advised, upon the first warning of the flow commencing, that the string 
around the waist should be loosened, and as many of the skirts removed 
as the temperature will permit; and this I have often found to give im- 
mediate relief to a great degree. 

If my theory as to the cause of so many of the cases of uterine dis- 
placement be correct, we have with it an explanation also of the ineffi- 
ciency of our means of remedying the disease. Any truss or abdominal 



362 ECLECTIC AND SUMMARY DEPARTMENT. 

supporter, to be efficient, acting precisely as the skirts do, by pressure 
externally upon the walls of the abdomen, must exercise a pressure 
fully equal to them before it can begin to do anything towards support- 
ing the uterus. This is too clear to require demonstration. If it does 
act with equal force, we ask what can be the situation of a woman with 
a twelve-pound force pressing downwards and a twelve-pound force- 
pressing upwards, upon the soft walls of the abdomen ? What chance 
have the organs within of doing their duty, and how long, under such 
treatment, will it be before she can expect to lay aside such aids and 
assistances and find herself a well and hearty woman, with the original 
complaint perfectly remedied ? 

As a palliative to the evil of wearing such oppressive garments, we 
always recommend that they should be supported by shoulder-straps ; 
and the suggestion of this simple expedient, imperfect as it is, has of 
itself brought us the heartiest thanks of the sufferers for the relief it 
has given them, assuring us that were the improvement carried further,, 
in lighter and more equally-supported garments, greater relief might 
be afforded to our patients ; and many, who are not such now, might be 
saved from becoming invalids. 

The importance of the subject, I trust, will be a sufficient apology 
for the length of this paper, which I have tried to make as concise as 
clearness will permit. With a view to this, I have omitted to relate 
particular cases, though I could give several, highly illustrative of the 
correctness of my views, as well as more especial confirmations from 
expressions of patients themselves, often clothed in the strongest lan- 
guage that relief from suffering and renewed health uses. 

In conclusion, I call attention to a moral aspect of the subject, viz. : 
that of all the peculiarities of woman's dress, which an appeal to the 
laws of physiology shows conclusively must seriously influence her 
health — low-necked dresses, corsets, tight and constraining waists, 
heavy skirts, narrow and thin-soled shoes — for not one of them is the 
shadow of a claim made that they contribute in the slightest to ease 
and comfort ; but, on the contrary, it is openly professed that they are 
used solely and entirely for the improvement of the figure. By which 
we are driven to the inevitable conclusion that either woman was sent 
"into this breathing world scarce half made up,' 7 or that French dress- 
makers have greatly improved upon the pattern as originally devised 
by the Creator. — Boston Medical Journal. 

Quackery. By AV. II. Stoker, M. D., of Boston. — In the year 1781, 
several of the most distinguished physicians of the State associated 
themselves together, and obtained an act of incorporation from the 
Legislature, under the name of the "Massachusetts Medical Society. ' ? 
By their charter, they are expected " from time to time to prescribe 
such a course of medical and surgical instruction, and such qualifica- 
tions as they shall judge requisite for candidates for the practice of 
physic and surgery, and shall cause the same to be annually published." 
This course is pursued, and well-educated young men yearly present 
themselves to the proper officers to be examined, and, proving them- 
selves to be competent, are allowed to become members of the society. 
But we look in vain in the chapter " concerning the practice of physic 
and surgery" in the State's laws, for a restraint upon irregular prac- 
titioners — for a prohibition that none, save well-educated men and such 
as have shown their capability by undergoing a thorough examination 
at the proper tribunal, shall be allowed to act the part of a physician 



ECLECTIC AND SUMMARY DEPARTMENT. 363 

or surgeon. And the young physician, a member of the Massachusetts 
Medical Society, who has been able by the most strenuous efforts — by 
great self-denial — oftentimes by embarrassing himself for years, in a 
pecuniary point of view, to reach the goal for which he had so long and 
so ardently striven, finds, upon entering the threshold of his profession, 
that he is surrounded by ignorant, uneducated, unprincipled men. who 
have no hesitation in publicly proclaiming that they can cure all dis- 
eases, and that, too, without resorting to any of those remedies against 
which they know many persons have an insurmountable objection — 
men who deluge the community with handbills and certificates of the 
most remarkable success, prepared for the occasion, or testified to by 
bribed or irresponsible persons. 

In no respect is our medical police more inefficient than in this. The 
evil I speak of has become a public nuisance, and as such it should be 
treated. A great portion of every community are exceedingly credulous 
— believing most fully whatever maybe stated, which, to an enlightened 
mind, savors of impossibility. The more ridiculous and improbable 
the accounts, the more readily do they attract attention ; and the greater 
the audacity of the narrator, the more certain, for a period, is he of 
succeeding. 

I have known a delicate female, wasted with phthisis, and requiring 
all the sympathy and attention of her most devoted friends, persuaded 
to place herself under the care of one of those wretches who blasphem- 
ously warrant a cure, and subjected to the most active treatment that 
could be devised. A few days only were required to free her of her 
misery. 

I have seen a strong day-laborer treated for inflammation of the 
bowels with the most stimulating drinks, crying in his agony for cold 
water, and supplied with potations of ruin and cayenne, and compelled, 
in his intervals of repose from the most acute suffering, constantly to 
repeat the dose. 

A few years since, a villain, who was said to have graduated from a 
Southern State prison, practised in our metropolis with immense suc- 
cess. Mercury and venesection, in his hands, controlled all diseases. 
The former in spoonful doses, and the latter to the utmost limit of the 
patient's strength, were employed indiscriminately. To use his own 
words, openly expressed and as openly boasted of, "he had drawn 
barrels of blood." Gross as were his proceedings, numerous as were 
the victims of his malpractice, there he remained, outraging the com- 
munity, until the relatives of a patient he had imposed upon and ruined 
made a public exposition of the case. 

But why should I adduce individual instances to prove my position, 
when, with others equally striking, most of you are undoubtedly 
familiar ? Besides, the physician, as such merely, can do but little in 
this hoped-for reform. However anxious he may be to do his duty as 
a good citizen, to exhibit the villany which exists on the one hand, and 
the unavoidable misery consequent upon it on the other, but few can 
appreciate his motives, or will give him credit for disinterestedness ; 
and he is literally compelled not only to see the grossest impositions 
inflicted upon his fellow-men, but to feel also that any interference on 
his part is the surest means of increasing them. It should be the duty, 
therefore, of those whose education and condition in life enable them 
to observe and comprehend the existing evil, to endeavor to remedy it. 
The better part of the community should act in unison upon this sub- 
ject, and then the object could be accomplished. — Address on Medical 
Jurisprudence. 



364 ECLECTIC AND SUMMARY DEPARTMENT. 

American Scientific Association. — This body, which recently met in 
Albany, transacted a large amount of business. Prof. Bache stated 
that since the first organization of the Association, there have been 
thus far 333 communications presented. Of these, 107 were on physico- 
mathematics, 32 on chemistry, 93 on mineralogy and geology, 83 on 
zoology and natural history, and the remainder on miscellaneous 
topics. 

Lieutenant Maury, of the National Observatory, read an interesting 
paper on 

Deep Sea Soundings. — At the commencement of this paper, he stated 
the very great obligations which he was under to this association. 
There were now under one system, which this association had rendered 
most material aid in approximating to perfection, over one thousand 
navigators in all parts of the world making observations on the tem- 
perature, the depth, the currents, and various other phenomena per- 
taining to the ocean. 

The great difficulty in making deep sea soundings was not to get a 
lead to the bottom, but to get it from the bottom. This difficulty had 
been in some degree overcome by a suggestion of Prof. Guyot, who had 
advised him to use twine instead of the strong line generally taken for 
that purpose, so that when the line reached the bottom and the mariner 
commenced to haul upon it, the line would break where it was fastened 
to the lead, while the length of the line would thus measure the depth 
of the locality where the sounding was made. But there were other 
difficulties to be overcome, and, as an instance of this, he would men- 
tion that on one occasion twenty thousand fathoms of twine was thrown 
away from the Albany. He mentioned with pleasure, in this connec- 
tion, Lieut. Taylor, of the navy, who had given his whole soul to this 
subject with an enthusiasm and zeal which he could not sufficiently 
praise. 

Lieut. Maury stated that a part of the difficulty had also been over- 
come by himself, he having devised a plan of timing the speed with 
which the twine reeled off; a waxed twine and anunwaxed twine giving 
different degrees of speed. The speed also varied as the depth increased, 
in a certain ratio, which had to be taken into the calculation. 

He exhibited on a very beautiful map the positions where several 
observations had been made, showing that in the Gulf of Mexico the 
John Adams had made observations which indicated a depth of five 
miles, while, the day after, the Albany had reached soundings at the 
depth of a quarter of a mile. He illustrated on the map how the tem- 
perature of the ocean varied, showing that the thermometer would 
indicate by its variations when a ship got on soundings, as it was 
a general rule the water on soundings was cooler than the currents 
which traverse the ocean. Off the Grand Banks, in winter, vessels will 
pass from the Gulf-stream to shallow waters in which the thermometer 
indicate a fall of thirty degrees. And so with the waters off the Dela- 
ware and the Chesapeake, where the cold waters of great rivers over- 
lapped the warmer waters of the ocean. 

In conclusion, he stated that the twine which he now used for deep 
sea soundings, though only of the thickness of ordinary whipcord, was 
made to sustain a weight of 120 pounds. — Newark Daily Adv. 

Report of an Obstetrical Case. By C. R. Palmore, M. D. — Mr. 
I'M or — Supposing the recital of the following case, which occurred in 
my practice whilst connected with the " Obstetric Institute" in Phikv 



ECLECTIC AND SUMMARY DEPARTMENT. 365 

delphia, will be acceptable to you, and interesting, if not instructive, 
to the readers of your valuable magazine, I have taken the liberty to 
transmit a condensed report of it from my case-book for publication. 
It involves a question in obstetricy which has always puzzled the young 
physician not a little, and which I hope this case will, at least, serve to 
direct the attention of practical physicians to the elucidation of the mys- 
tery with which teachers and books have surrounded it. 

Case. — April 10, 1850. Mrs. M. G. was seized with labor pains this 
morning. The labor proceeded very well (the vertex presenting in the 
first position), till the head emerged from the vulva. At this time the 
child took several deep inspirations and cried lustily. I immediately 
perceived, however, the umbilical cord around its neck, and, on more 
minute observation, discovered it drawn thrice very closely. The pains 
were now very severe, of the expulsive kind, which caused the funis to 
become tighter at every effort. I endeavored to pull the cord down and 
pass it over the head, but soon found the attempt useless from its ex- 
treme tenseness. I next attempted to disengage and suffer it to pass 
over the shoulders as they descended. This was also of no avail, for I 
could scarcely insert one finger between the cord and neck, so closely 
was it fastened. My next duty, I conceived, was to suffer it to remain, 
or, in other words, trust to the vis medicatrix natural. This negative 
plan was as nugatory as the others had been unfortunate. The child, 
which before had cried, now ceased. Its face became at first dusky, 
then black, exhibiting plainly the compression of the jugular veins and 
the consequent stagnation of blood in the brain. Here, then, was no 
time to be lost. 

The only alternative at my command was to sever the funis. But 
here (I should not call it aclemon), authority arose before me. Dewees, 
Ramsbotham, Meigs, Hodge, whose opinions we all recognize, passed 
in rapid review. I remembered only one similar case, that mentioned 
in Dr. Meigs' " Treatise on Obstetrics, " page 295. That this was a 
similar case, I had no doubt. I resolved, therefore, to cut the cord, 
which having been done, the child, released from its halter, soon re- 
vived ; its face gradually assumed its natural hue ; its breathing again 
commenced, and the mother's heart was illumed afresh by its reawak- 
ened cry. A few bearing down pains soon sufficed to drive the child 
from the vulva. I now tied the cord. Nothing unusual occurred in 
the after treatment. 

Remarks. — It will be noticed that I pursued the usual course of treat- 
ment laid down in the books, and found this routine practice totally 
unavailing. Since the occurrence of the above case, I have examined 
the subject pretty closely, have maturely considered the salient points 
of the practice, and have come to the conclusion that the treatment 
usually recommended is, at least, irrational, if not radically defective, 
and that it will not answer in practice. 

Upon a superficial examination, I know some may say that the suc- 
cess of the above case was post hoc, and not propter hoc. But if such 
persons would examine attentively the details given, they could not, in 
my opinion, refrain from being convinced that it was propter hoc. 

What are the dangers that are so particularly inculcated by teachers ? 
There is only one, and, to my mind, this scarcely deserves the name of 
danger. I refer to the supposed probability of the child's dying from 
loss of blood. I say supposed, because I cannot conceive why this can 
take place, as the child's body presses the cord against the vulva, 
effectually serving the purpose of a ligature. And this actually occurred 



366 ECLECTIC AND SUMMARY DEPARTMENT. 

in the case I have just narrated. The loss of blood was scarcely ap- 
preciable. This is the most prominent, if not the only objection that 
can be urged against the treatment. 

The advantages are numerous and, in my opinion, insuperable. It 
saves the child from impending death, and it empties the placenta of 
its retained blood, thus allowing it to be more easily detached by the 
efforts of the uterus, or, if necessary, by the hand. Moreover, if the 
cord were suffered to remain around the neck, and the child to descend, 
the cord might be torn from the placenta by the roots, or else it 
might draw the fundus of the uterus after it, and thus cause inversio 
uteri. 

Those who have had this latter affection to deal with, will easily 
appreciate any plan recommended for its partial prevention. — Stetho- 
scope and Virg. Med. Gazette. 

American Medical Association. Prize Essays. — At a meeting of the 
American Medical Association, held in Charleston, S. C, in May last, 
the undersigned were appointed a committee to receive and examine 
such voluntary communications on subjects connected with medical 
science as individuals might see fit to make, and to award a prize to 
any number of them not exceeding five, if they should be regarded as 
entitled to such a distinction. 

To carry into effect the intentions of the association, notice is hereby 
given that all such communications must be sent, post-paid, on or 
before the first day of April, 1852, to Geo. Hayward, M. D., Boston, 
Mass. Each communication must be accompanied by a sealed packet 
containing the name of the author, which will not be opened unless the 
accompanying communication be deemed worthy of a prize. The au- 
thors of the unsuccessful papers may receive them on application to 
the committee, at any time after the first of June, 1852 ; and the suc- 
cessful ones, it is understood, will be printed in the Transactions of the 
Association. 

GEORGE HAYWARD, Boston. 

J. B. S. JACKSON, 

D. H. STORER, 

JACOB BIGELOW, 

USHER PARSONS, Providence, R. I. 
Boston, Aug. 20th, 1851. 

Editors of Medical journals throughout the United States are re- 
spectfully requested to give the above one insertion in their respective 
journals. 

Decay of Teeth. — Civilization has been marked by the appearance of 
a premature destruction of the teeth. No one organ, under ordinary 
circumstances, should fail any sooner than another. All the senses, 
when not abused, are tolerably active to advanced old age, when they 
operat3 less perfectly, each of them being only maintained by the har- 
monious movement of the others. At the expiration of three score and 
ten, some of the delicate interior structures, under the action of com- 
bined forces that belong to civilization, ordinarily give out. One 
becomes deaf who has, perhaps, been subjected to the shock of an ex- 
plosion ; another has dim vision, because he has habitually allowed 
injurious cases to operate that might have been avoided ; and so on in 
regard to the violation of many of the laws of our nature. 



ECLECTIC AND SUMMARY DEPARTMENT. 367 

The northern parts of the United States are proverbial for the bad 
teeth of the inhabitants, and for a long while the question has been 
agitated — what is the cause of it? Every answer but the right seems 
to have been given. One of the journals, the name of which is not 
recollected,* recently intimated that our food does not contain phosphate 
of lime enough to meet the exigencies of the system. This idea strikes 
us as being correct. In no country do so many people uniformly con- 
sume fine flour for habitual food as in the Northern States. By throwing 
aside the bran, we actually deprive ourselves of that portion of the 
grain which, it may be supposed, contains the material for keeping the 
teeth in repair. A persistence in this habit of using none but bolted 
wheat, for two generations, is quite sufficient to lay the foundation of a 
constitutional or hereditary tendency to bad teeth. The Western and 
Southern inhabitants are preparing for the same misfortune in their 
posterity, since fine-bolted flour is becoming the staple article of food 
with them. Bolting-mills were put in operation in New England. 
Here poor teeth first began to appear, and here they will always abound, 
should this cause prove the true one, till a more simple preparation of 
bread has been adopted long enough to overcome the defect in the 
parent stock. 

Dentists are frank in warning their customers of the vices to which 
they are slaves, but to little purpose ; and so we go on, from family to 
family, mending, stopping, and plugging up carious breaks in the 
enamel, till, in after ages, the native Bedouins of ancient America will 
ransack the tombs for the gold in the teeth of the buried millions, as 
they are now pounding up the mummies at the Necropolis of Sakkara, 
to find rings and jewelry buried on the ancient Egyptians. 

Very much may be done for children, where a tendency to a pre- 
mature decay of the teeth is discoverable, by strict attention to diet: 
simple food, never hot ; and coarse bread, particularly from unbolted 
flour. Our food is too concentrated. It should be coarser. Nature 
has infused into the material for supporting animal life all the elements 
necessary for maintaining the stability of the vital mechanism. By 
bolting flour we have disordered her arrangement, and must expect to 
suffer the consequences. — Editorial in Boston Journal. 

Supposed influence of Tobacco as an Antidote to Arsenic. — Dr. Henry 
J. Bowditch, of Boston, publishes in the Boston Medical Journal, of 
July 16th, some cases reported to him by Dr. A. J. Skilton, of Troy, 
N. Y., in which he has emplo}^ed an infusion of tobacco very success- 
fully as a remedy against poisoning by arsenic. We would gladly 
give place to the entire article, but our limited space forbids. From a 
discussion, which took place at a late meeting of the Troy Medical 
Association on one of Dr. Skilton's cases, he has been led to adopt the 
following as the modus operandi of tobacco as an antidote to arsenic : 
"And that it is a sufficient, an effectual, antidote/' says Dr. S., "I 
have become satisfied. Arsenic kills by first exciting inflammation of 
the stomach ; at least, so it is in all cases where it is introduced into 
that viscus. Tobacco, a powerful sedative narcotic, probably acts by 
benumbing the nerves of the stomach, and thence preventing or curing 
inflammation of the mucous coat of the organ." 

Dr. Skilton's observations are certainly entitled to consideration, 
and, if they should be verified, it is evident, from the difficulty in pro- 

* See N. J. Medical Reporter, vol. iv. p. 1, 



368 ECLECTIC AND SUMMARY DEPARTMENT. 

curing, on short notice, an antidote to this favorite poison, that they 
are of great importance. * 

Case of Gunshot Wound of the Spine. Communicated by Charles 
S. Triple r, M. D., Surgeon U. S. Army. — The interesting and important 
discovery of the reflex function of the spinal nerves, promises so much 
benefit to the science of medicine, that no fact tending to illustrate or 
establish Dr. Hall's views can be looked upon with indifference. I, 
therefore, take great pleasure in communicating the following notes of 
an interesting case, which I made at the bedside of a patient a short 
time ago. I shall make no remarks upon it, preferring to submit it as 
it is for the use of Dr. Hall himself, should it ever meet his eye. I 
may, however, be indulged in suggesting that the practical surgeon 
may derive a hint from it that may save himself and his patient some 
trouble in a similar case ; for, if the titillation of an afferent nerve may, 
through reflex action, enable him to dispense with the use of the catheter 
and enemata, it will be no trifling point gained. 

During the protracted war with the Seminole Indians in Florida, an 
officer, traveling from St. Augustine to Picolata, was waylaid and 
wounded by a party of those savages. He was seated upon the floor of 
a common baggage-wagon ; the ball passed through the side of the 
vehicle before striking him. He was shot on the line of the union of 
the last dorsal, with the first lumbar vertebra — the ball penetrating at 
the angle of the ribs, on the right side, two inches above the vertebra, 
and passing in a direction obliquely downwards and toward the spine. 
The general direction of the wound was ascertained by the probe, but 
the ball could not be felt, and where it is lodged remains a mystery to 
this day. 

This took place on the 25th of November, 1839. The immediate 
consequences were loss of motion and sensation below the wounded 
part, though the sensorial recognition of the lower extremities was that 
of numbness and tumefaction. When he was received into the hos- 
pital, bottles of hot water were applied to his legs, with the effect of 
causing deep eschars very rapidly, but without producing any sensa- 
tion. The gunshot wound healed very readily, leaving the patient in 
the following condition: The line of normal sensation began in front, 
at the interior superior spinous process of the ilium, descended almost 
in the direction of Poupart's ligament about half its length, then curved 
upwards, passed just below the umbilicus, described a similar curve on 
the other side, and then passed around the back, in nearly a right line, 
to the point of departure. 

The bladder and the rectum were paralyzed ; the one was relieved by 
the catheter, the other by castor oil. The use of the oil was continued 
for about two } T ears ; afterwards enemata were substituted ; lavements 
of water are still used occasionally. The feces are passed without sen- 
sation. The catheter was used for about a year, or a little more. xVbout 
the beginning of the year 1841, he found that the bladder could be in- 
duced to contract by tickling the side of the penis, just behind the corona 
glandis, and he afterwards discovered that the same manipulation would 
provoke the rectum to discharge its contents, no sensation, in the mean- 
while, being transmitted to the sensorium. 

He thinks that titillation of the left side of the penis affects the rec- 
tum more than the same operation upon the right. 

JS T o sensation of distended bladder calls for relief; but contraction of 



ECLECTIC AND SUMMARY DEPARTMENT. 369 

the toes and abduction of both thighs occur at this time, warning the 
patient of the wants of nature. 

Priapism was readily excited, for a time, by friction upon the back 
or breast ; but this seems to have subsided of late years. 

The flexors of the toes are permanently about half contracted ; by 
tickling or jerking up the scrotum and testicles, these muscles may be 
made to act spasmodically. 

The temperature of the paralyzed parts is good. He thinks he feels 
more and more, from year to year, a consciousness of the existence of 
the limbs, and, by an effort of the mind to fix attention upon them, 
they ache so much as to render it necessary to desist. 

There is not so much corpulency of body as is usual in such cases, 
nor are the paralyzed extremities so much atrophied as we might 
expect. 

All sorts of counter-irritations, hydropathy, homoeopathy, electricity, 
strychnia, &c, have been resorted to, but without benefit. In 1844 or 
1845, while trying the sulphur vapor, a jet of hot vapor was thrown 
upon the sole of the left foot, and took off the whole integument, he 
being totally unconscious of any sensation. 

The urine was ammoniacal and purulent for the first three or four 
years, but has been less offensive since. If he assumes the erect posi- 
tion, leaning upon his crutches, to empty the bladder, the urine is less 
offensive than when he was obliged to lie in bed for a few days. 

The color of the limbs is natural. He assures me that they were, 
a few years ago, more sallow and more atrophied. — iV. Y. Journal of 
Medicine. 

Diuretic Formula. By T. S. Bell. ( Western Journal Med. and Surg.) 
— [After a brief allusion to the paper of Dr. Hook, in the November 
number of this journal, for 1850, on the use of watermelon seed as a 
diuretic, which he corroborates, Dr. Bell says] : — 

But we can assure Dr. Hook that we have seen much finer diuretic 
effects from the formula we subjoin, than from any other diuretic we 
have ever used. It has often succeeded when all others failed. In 
1838 we reported, in the predecessor of this journal, a very remarkable 
case of suffering in the kidneys and bladder, in which the calls to 
urinate were almost incessant for two days and nights, and only one or 
two drops of urine could be passed at a time. The pain complained of 
resembled that attendant upon stone in the bladder. Hip bathing, 
purgatives, emetics, opiates, and the usual round of diuretics, failed to 
give any relief. The patient seemed to be sinking rapidly under the 
combined effects of pain, agitation, vigilance, and exhaustion. The 
antilithic paste was then resorted to, for the first time, by the writer, 
and, in less than half an hour after it was given, the patient was easy 
and slept for several hours. The kidneys acted freely, and all suffering 
ceased. Since that time, abundant opportunities have presented them- 
selves for the use of this paste, and its effects are uniformly all that the 
physician and patient can desire. 

The formula for this paste was taught by Prof. John E. Cooke, and 
he gave strong testimony to its value. The following is the recipe : 
R. Castile Soap^iv; Spermaceti ^viij ; Ven. Turpentine gvj ; 01. 
Aniseed giij ; Turmeric gij ; Honey q. s. Rub the soap and spermaceti 
well together : then add the turmeric ; after rubbing them well, add 
turpentine and ol. aniseed, and sweeten with honey. 

Of this paste, a piece the size of a walnut is given two or three times 



370 ECLECTIC AND SUMMARY DEPARTMENT. 

a day. The diseases in which it is most useful are those in which the 
mucous membrane is involved. There is a species of hoarseness which 
follows inflammatory action, and which often approaches aphonia, in 
which this paste is a very valuable remedy.— Charleston Medical Jour, 

Medical Statistics. — Dr. Casper, the indefatigable statistician, has had 
the idea of drawing up tables of vital statistics, bearing upon the medi- 
cal profession. These tables are of great extent, and contain very 
interesting details. We must confine ourselves to the following facts: 
The number of Prussian practitioners is about 3,452 ; their age varies 
in the following ratio: there are 1,873 from 24 to 36 years old; 737 
from 37 to 46 ; 561 from 47 to 56 ; 190 from 57 to 66 ; 87 from 67 to 76 ; 
and 4 beyond 77. It will thus be seen that fully one-third are not 30 
years old, and that hardly one-sixth reach 60. — Lancet, May 24th, 1851. 

Case of Birth after death of the Mother. — Dr. Scneider relates that 
being summoned in haste to a woman in labor, he found her dead on 
his arrival. On placing the hand on the yet warm abdomen, he felt 
the uterus contracted and sunk in the pelvis. By an examination per 
vaginam, a foot was detected, and, by rapidly completing the delivery, 
he had the satisfaction of bringing into the world an apparently still- 
born child, which, however, soon revived. — Casper's Wochenschrift ; 
and British American Medical and Physical Journal, April, 1851. 

Varicose Dilatation of the Vessels of the Prepuce. — M. Beau {Revue 
Medico- Chirurgicale, Janv.), describes a condition of the prepuce which 
has not been noticed by previous writers, and which depends on a vari- 
cose dilatation of the lymphatics of the part. This lesion appears as a 
transparent cord, resistant and hard to the finger. The fluid which it 
contains is perfectly limpid. The disease generally appears suddenly 
after friction of the prepuce during coition, and after a time it is pro- 
duced by simple erection. At first it speedily subsides after the excit- 
ing cause is removed, but eventually it becomes permanent, and in 
some cases becomes as large as a crow-quill. The treatment, when 
recent, is onfined to simple measures, such as demulcent or astringent 
lotions. In the chronic state it may be cured by causing obliteration 
of the duct, by means of a thread passed through it. — Prov. Med. and 
Surg. Journal. 

On the Absorption of Alimentary Substances and the Functions of the 
Lacteals. By M. C. Bernard. [Gazette Medicate). — M. Bernard read 
a memoir on this subject, in which he proposed to determine, by direct 
experiment, the nature of the nutritive principles which are absorbed 
and conveyed by the chyliferous vessels, in order to ascertain if there 
really exist any alimentary substances which absolutely escape venous 
absorption, and consequently avoid passing through the liver before 
arriving at the lungs. 

Alimentary substances submitted to digestion are, in the intestinal 
canal, finally reduced to three principal substances — the saccharine, 
the albuminous, and the fatty emulsive ; on these M. Bernard has in- 
stituted experiments: — 

1. With regard to the absorption of Sugar by the Lacteals. — On inject- 
ing large quantities of sugar into the stomachs of different mammiferae, 
it has been found in the blood of the portal vein, while it was absent 
from the chyle of the thoracic duct at the same time and under the same 



ECLECTIC AND SUMMARY DEPARTMENT. 371 

circumstances ; whence it is concluded that sugar, before arriving at 
the lungs, traverses the liver, where it undergoes a peculiar physical 
modification. If a solution of grape sugar be injected into the super- 
ficial veins of a dog, it speedily passes off by the urine ; on the contrary, 
if the solution of sugar be injected into the radicles of the portal vein, 
the sugar is no longer eliminated by the kidneys, but passes into the 
circulation, and is assimilated in the same manner as if taken into the 
digestive canal. Thus it is shown that the absorption of sugar by the 
portal system is a condition essential to its assimilation, since, if confined 
to the lacteals, the saccharine principle is abstracted from the influence 
of the liver, and is diverted directly into the general venous circulation, 
as takes place when it is injected by the jugular vein. 

2. As to the absorption of Albumen by the Lacteals. — Albumen injected 
into the general venous circulation soon appeared in the urine. If in- 
jected into the portal vein, it does not then appear in the urine, but is 
assimilated in the same manner as obtains with sugar. 

3. Absorption of Fat. — M. Bernard's previous researches have shown 
that fatty matters are not capable of admission into the lacteals until 
an emulsion has been formed by the action of the pancreatic juice. 
Immediately that this emulsion has penetrated the lacteals, their aspect 
undergoes an entire change ; instead of remaining transparent, like 
other lymphatics of other parts of the body, they assume a milk-white 
appearance, and, owing to the transparency of the coats of these ves- 
sels, the course of the fatty matter may be followed from the intestine 
to the subclavian vein, where it is diverted into the thoracic duct. It 
is not necessary that fatty matters should traverse the liver in order to 
their assimilation. M. Bernard has injected fatty emulsions into the 
jugular vein, but has not found that substance in the urine. 

Thus the products of digestion may be distinguished, with reference 
to absorption, into two groups — e. g., 1st, fatty and albuminous matter 
absorbed by the lacteals, passing into the general circulation without 
having traversed the liver. The last proposition cannot be taken in so 
absolute a sense as the former, since experiment and microscopical 
examination demonstrate that fatty matters are absorbed both by the 
portal system and by the lacteals. — Charleston Medical Journal. 

On the Therapeutical Employment of Coffee and Caffeine. By MM. 
Vanden-Corput and Hannon. {Brit, and For. Med. Rev., Oct. 1850, 
from Bulletin de Therap.). — M. Vanden-Corput has recently published 
an article upon the febrifuge power of coffee, and especially its anti- 
neuralgic action, on which account it is now very much employed by 
the Belgian practitioners. Numerous therapeutical applications of this 
substance were made long since. Nebelius and Baglivi gave it in 
cephalalgia ; Dufour prescribed it in phthisis and migraine ; Willis 
employed it in a narcotic poisoning ; and Grindel and Dorpat as a febri- 
fuge. Musgrave, Pringle, Monin, Percival, Laennec, and a great many- 
others, have spoken of it approvingly in essential asthma. In Dutch 
Batavia it is used in strong infusion, with lemon-juice, in pernicious 
fevers, and the practice, passing thence to Holland, has led to its being 
preferred there to quinine. Pouqueville declares it is infallible in the 
intermittens of the Morea, and Martin-Solon approves of its use in the 
adynamic form of typhoid. Dr. Guyot has recently strongly recom- 
mended it in pertussis. Besides medicinal properties, properly so called, 
it possesses the important one of disguising the taste of various sub- 
stances, especially quinine, sulph. magnesia, and senna ; and, if its anti- 



372 ECLECTIC AND SUMMARY DEPARTMENT. 

periodic virtues really exist, it will probably favor the action of quinine 
instead of impairing it, as has been feared by some. It possesses the 
power, too, of developing the action of haschisch, contrary as this may 
seem to its generally acknowledged anti-narcotic properties. 

M. Hannon speaks in the highest terms of the employment of the 
citrate of cafeine in idiopathic migraine. Ten grains are first made into 
as many pills, one of which is given every hour for some time before 
the paroxysm. The dose is gradually increased until relief is obtained, 
and, in one case, even half a drachm at a time was given. The dose 
must, indeed, be large, in proportion to the obstinacy of the case and 
the length of time between the paroxysms. Large doses are also re- 
quired in old, feeble, or cachetic patients, and in old cases the medicine 
must be long continued. It is desirable, when possible, to commence 
the medicine the evening before the exyected paroxysm, when the entire 
quantity may be divided into several doses ; but if it has been delayed 
until the commencement of the paroxysm, the whole quantity must 
then be given at once. The expected paroxysm may thus be entirely 
arrested, or merely diminished in severity ; but, in all cases, save where 
the disease is sympathetic, it eventually yields. 

While upon the subject of migraine, we may mention a still pleasanter 
remedy than coffee, suggested by M. Tavignot, viz., the making several 
deep inspirations in rapid succession. We must observe, however, that 
M. Tavignot does not understand by the term migraine simple neuralgia 
of the head, which many writers so designate ; but the condition when 
this is accompanied by a state of physical and moral prostration, during 
which the blackest ideas assail the patient — the "blue-devils," in fact, 
to which the English were once thought, on the continent, to be espe- 
cially liable. During an attack of this, which, from former experience, 
he was led to believe would continue for twenty-four hours, he was 
induced, by the hope that this condition of the nervous centres might 
result from a stasis of the blood in the sinuses of the brain, or from 
imperfect hsematosis, to take several deep and rapid inspirations ; and, 
after a few efforts of this, he found himself completely relieved and able 
to resume his occupations. Other persons, similarly affected, have been 
in like manner relieved ; but those who have tried the plan in simple 
neuralgia have been disappointed. — Ibid. 



HARVARD UNIVERSITY f 

Library of the Medical School *%. 



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* 



f 




The Warren Library 

Dr. John Warren 
1753-1815 

Dr. John Collins Warren 

1778-1856 

Dr. Jonathan Mason Warren 

1811-1867 

Dr. John Collins Warren 
1842-1927 

Dr. John Warren 
1874-1928 



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